Care Services Research Articles

Results of a National Delphi consensus on the outpatient management of pediatric psychogenic nonepileptic seizures in the United States

Background and objectivesThe purpose of this study was to develop national consensus based on expert opinion on the optimal outpatient care model of pediatric psychogenic nonepileptic seizures (PNES). MethodsA core working group (CWG) within the PNES special interest group of the Pediatric Epilepsy Research Consortium was established. The CWG developed a rigorous scoring rubric to select experts in pediatric PNES within the United States of America and a three-round Delphi study was conducted to assess consensus on key components of the management of pediatric PNES in the outpatient setting. ResultsEighteen experts representing neurology, psychology, psychiatry, social work and nursing participated in the study. Strong consensus was reached that the multidisciplinary clinic (MDC) model is the gold standard for the outpatient management of pediatric PNES. Consensus was obtained that a neurologist, psychologist and social worker are essential members of the MDC and in the setting of unlimited resources, psychiatry and nursing are also recommended. Further consensus was established on the roles of specific personnel, structure of the clinic, billing practices, trainee inclusion, patient inclusion and exclusion, and end of visit management. While consensus was reached that a new term should be developed for this diagnosis, consensus was not reached on the ideal term. DiscussionExpert consensus was established for the multidisciplinary management of pediatric PNES in the outpatient setting. Specific recommendations were provided that can facilitate the development and implementation of MDCs in other institutions. Further prospective studies are warranted to validate this practice model.

Universal distress thermometer screening by a social worker among gynecologic oncology patients improves the rate of distress screening

Universal distress thermometer screening by a social worker among gynecologic oncology patients improves the rate of distress screening

Analyzing the interplay between social media analytics and nudges in pandemic control

This study employs a data-driven approach to examine the government's use of data insights and nudges to promote social distancing during the pandemic. Drawing from well-established technology adoption theories, a nationwide online survey was conducted among professionals and postgraduate students adapting to remote work and learning. The study unveils that access to suitable information and communication technology (ICT) significantly influences people's willingness to adhere to social distancing and work from home (WFH). Moreover, respondents' expectations of WFH's impact on job performance emerged as a critical driver for sustained social distancing, with individuals' habits playing a pivotal role in enhancing WFH performance expectancy. Notably, the study pioneers in exploring the psychological effects of government nudges during a pandemic, shedding light on an uncharted aspect of pandemic control strategies.

Enhancing the role of social work in managing cancer risks among LGBTQ+ populations.

Enhancing the role of social work in managing cancer risks among LGBTQ+ populations.

Strengthening the pain care ecosystem to support equitable, person-centered, high-value musculoskeletal pain care

Abstract Improving health and wellbeing outcomes for people experiencing chronic musculoskeletal pain requires collective efforts across multiple levels of a healthcare ecosystem. System-wide barriers to care equity must however be addressed (eg, lack of co-designed services; overuse of low value care/underuse of high value care; inadequate health workforce; inappropriate funding models; inequitable access to medicines and technologies; inadequate research and innovation). In this narrative review, utilizing a systems’ thinking framework, we synthesize novel insights on chronic musculoskeletal pain research contextualized through the lens of this complex, interconnected system, the “pain care ecosystem.” We examine the application of systems strengthening research to build capacity across this ecosystem to support equitable person-centred care and healthy ageing across the lifespan. This dynamic ecosystem is characterized by three interconnected levels. At its centre is the person experiencing chronic musculoskeletal pain (micro-level). This level is connected with health services and health workforce operating to co-design and deliver person-centred care (meso-level), underpinned further upstream by contemporary health and social care systems (macro-level context). We provide emerging evidence for how we, and others, are working towards building ecosystem resilience to support quality musculoskeletal pain care: at the macro-level (eg, informing musculoskeletal policy and health strategy priorities); at the meso-level (eg, service co-design across care settings; health workforce capacity); and downstream, at the micro-level (eg, person-centred care). We outline the mechanisms and methodologies utilized and explain the outcomes, insights and impact of this research, supported by real world examples extending from Australian to global settings.

Using a Capability Approach to Explore How People With Intellectual Disabilities Can Lead Flourishing Lives.

People with intellectual disabilities remain disadvantaged in many aspects of everyday life. Capability approach is an underused approach in social care research and has at its core the importance of having capabilities or opportunities to do what we value. We use this approach to explore how people with intellectual disabilities can be supported to lead flourishing lives. Interviews and focus groups were conducted with 50 people with intellectual disabilities and 28 family carers. Data were analysed using an adapted template approach and conceptual analysis. Our analysis led to the identification of one overarching theme; 'Doing what you love and growing' and sub-themes; 'Choice, opportunity and empowerment', 'Being out in the world' and 'Lowered expectations and static lives'. People with intellectual disabilities can lead capability-deprived lives. Methodological and practice innovation is needed to better understand what people value and ensure they have capability sets that enable flourishing lives.

Fighting for Ben, a family’s story

Purpose This paper aims to study themes of abuse and mistreatment of people with a learning disability. Personal stories of lived experience such as this are important pieces of learning and information for practitioners. This case study is intended to add to the limited available knowledge base of lived experience, offering insight into safeguarding in practice. Design/methodology/approach This is a single case study highlighting lived experiences written by and from the perspective of a sibling of a person with a learning disability who has experienced abuse in the social-care system. Findings Structural ongoing abuse occurs and has occurred in the social care system. How we respond to this as a system and societally is a multi-layered challenge that underpins the ability to ensure the safety and well-being of the most vulnerable peers. Originality/value Case studies such as this are limited, with underpinning themes that are all too common. The case study adds to literature that gives insight and perspective into experiences of systems, and of systemic failures to act.

The Role of Artificial Intelligence (AI) and machine learning in social work practice

The integration of Artificial Intelligence (AI) and Machine Learning (ML) into social work practice is transforming the landscape of service delivery and decision-making. This paper explores how these technologies enhance case management, predictive analytics, and resource allocation in critical areas such as child welfare, mental health, and substance abuse treatment. Key trends highlighted include the use of AI-based predictive analytics to identify at-risk populations and facilitate early interventions, as well as the deployment of chatbots and virtual assistants for providing accessible mental health counselling and social support. Furthermore, the paper addresses ethical considerations and challenges associated with AI implementation, particularly the potential biases in algorithms that may affect the assessment of social needs. Additionally, the integration of AI tools into social work education and training is examined to prepare future professionals for a technology-driven environment. By analysing the current applications of Natural Language Processing (NLP) for client data analysis, AI-powered software for predictive risk assessments, and automated case management systems, this paper advocates for a balanced approach to AI adoption, ensuring that the core values of social work, such as equity and social justice, remain central to practice. Ultimately, this exploration underscores the potential of AI and ML to enhance social work outcomes while also emphasizing the necessity of ethical frameworks and ongoing training for practitioners.

Mental health and job satisfaction among social workers a quantitative study an analysis of workplace well-being in the social work profession

Mental health and job satisfaction among social workers a quantitative study an analysis of workplace well-being in the social work profession

Sida cordifolia Linn- An widely used herbs in the village of Falta, west Bengal, India: Pharmacological evaluation of antiepileptic activity of root extract of Sida cordifolia Linn.

As per the observation of the social work activitist it was found that the raw extract of the root of Sida cordifolia Linn. Are been used by some old people in the village of Falta Block of South 24 PGS district of West Bengal, India to treat epileptic attack on some villagers. The identified plant were collected and handed over the research scientists for the further study. The dried coarse powder of the root of Sida cordifolia Linn. Were soxheleted successively with petroleum ether (PESC), methanol (MESE), with boiled water (AESC) and the epileptic study was performed on the Albino mice using 100 and 300 mg/kg body weight of PESC, MESE and using clonazepam as standard using Maximum Electroshock induced seizure model and result depicted that PESC exhibited a significant antiepileptic effect at both low and high doses where as MESC exhibited the significant antiepileptic effect only at high dose. Hence, the petroleum ether extract may be chosen to be more effective than that of the methanol extract.

A novel operational protocol for the establishment of a medical facility for receiving returning hostages: structure, process and outcomes

BackgroundOn October 7, 2023, Hamas carried out an unprecedented attack on the State of Israel and kidnapped 251 people into captivity to the Gaza Strip. Several months later, as part of a humanitarian exchange deal, 105 hostages were released in five phases and admitted to one of six hospitals throughout the country for treatment. Shamir Medical Center (SMC) was one of these facilities. This study aims to describe the structure, process and outcomes of establishing a comprehensive, multi-step, operational protocol for receiving hostages returning from captivity.MethodThe process of preparing SMC as a receiving center, the establishment of procedures for implementation of the medical protocol, and the assessment of multi-disciplinary team preparedness and implementation and outcomes in an institutional protocol are described.Results24 returning hostages were received at SMC. Social workers, dietitians and translators were used by 100% of the majority group of returning hostages from the same country of origin and the sole individual from the other country of origin utilized a dietitian, social worker, ENT consultations, and a hearing test. Among the majority group, orthopedic and dermatological consultations were utilized by 17.4% and 13% received an ENT consultation. Of the administered imaging, 13% received a chest X-ray, 8.7% received a limb X-ray, 17.4% received a head CT scan, and 4.3% received an abdominal CT. In addition, 21.7% were provided antibiotic therapy. Protocol efficacy was measured by assessing time to various operational aspects of protocol implementation and medical procedures such as mean hours to room assignment, primary physician evaluation and social worker session. No correlation between age and operational variables was found.ConclusionThis novel operational protocol was successfully implemented and may serve as a framework for managing similar unpredictable sensitive events in the case of future need.

Lessons learned from implementing a digital rehabilitation care planning platform to improve care access for patients with work disability: qualitative process evaluation of the RehaPro-SERVE study

BackgroundInpatient rehabilitation therapies can be applied for in Germany by patients of working age to support their return to work. However, there are some problems that impede an easy and uncomplicated application process. An interdisciplinary case management approach for rehabilitation care planning was developed to facilitate the access to rehabilitation. Case conferences (CCs) were held with relevant stakeholders and took place on a digital communication platform. We conducted a qualitative process evaluation to understand the implementation of the intervention and to identify contextual factors as well as mechanisms for a successful implementation in the context of primary care.MethodsThe process evaluation included interviews with primary care physicians (PCPs), patients and stakeholders involved in the intervention process. Reflexive thematic analysis was used to analyse the data. Emerging themes were structured according to the Donabedian framework of structure, process and outcomes.ResultsA total of 18 interviews were conducted. Important results included the desire for more patient involvement and case management. Patients especially valued the opportunity to receive support from a social worker. Limitations of the platform related to usability and limited opportunities for stakeholder communication. Despite training for PCPs, several problems arose regarding the clarity of the intervention process. Patients were satisfied with their application process and the treatments offered, while PCPs reported an increase in workload.ConclusionsA digitalisation of the application procedure for rehabilitation and further treatment options is acceptable to patients and personal support of a social worker is particularly valued. However, patients should be included in the CC in terms of a shared decision-making process. The digital platform requires sufficient training and adjustments have to be made to enhance usability and to improve the efficiency of the process for PCPs. Overall, the exchange between the various stakeholders in the CC is considered particularly useful in more complex cases.Trial registrationDRKS German Clinical Trials Register, DRKS0 00242 07. Registered on 22 March 2021.

Gender Distribution of Editorial Board Members in Palliative Care Journals: Assessment of Gender Parity.

Objective: Although the representation of women in palliative care has improved in recent years, gender inequality still exists in editorial leadership. This study aimed to characterize gender distribution in leadership positions on the editorial boards of palliative care journals. Methods: This cross-sectional study analyzed the gender composition of editorial boards for palliative care journals indexed in the Web of Science (WoS) and the factors that affect this composition. Information on the gender of editorial board members was obtained from each journal's website. Results: A total of 1388 editorial board members from 28 palliative care journals were included in the analysis. The data analysis showed that 540 (38.9%) of the editorial board members were women, while 848 (61.1%) were men. Of the 31 editors-in-chief, only 11 (35.5%) were women. Editorial boards of journals classified as social work (OR, 5.92, 95% CI, 2.29-15.30, p < 0.001) and nursing (OR, 4.20, 95% CI, 1.73-10.17, p = 0.001) in WoS coverage were independently associated with gender diversity. There were differences in gender representation between the editorial boards of palliative care journals published in New Zealand (OR, 0.49, 95% CI, 0.29-0.80, p = 0.005), Japan (OR, 0.17, 95% CI, 0.08-0.32, p < 0.001), and those categorized under oncology in WoS coverage (OR, 0.64, 95% CI, 0.05-0.89, p = 0.009). Conclusions: Our findings demonstrated that women are underrepresented among editorial board members of palliative care journals. Additional efforts are required to broaden diversity policies in palliative care.

Experiences of psychological, social and organisational work environments in occupational health service in Sweden: a cross-sectional survey

BackgroundThe aim of this study was to compare and describe different professionals’ experiences of workplace psychological and social factors in occupational health (OH) organizations in Sweden.MethodsThis cross-sectional study with a descriptive and comparative design included 472 respondents with common professions in the occupational health service (OHS) in Sweden. Data were collected with “The General Nordic Questionnaire for Psychological and Social Factors at Work” (QPSNordic). The professions have been compared pairwise using the Independent Samples Kruskal-Wallis test, adjusted by Bonferroni correction for multiple tests on subscales and single items and these are presented descriptively.ResultsThe experience of the psychological and social work environment on job task measurement level differed between the professionals. Experiences on social and organizational as well as on individual measurement levels are similar between the professionals who perceive them as satisfactory. Out of the 472 respondents, 7% reported that they had seen someone being subjected to harassment and bullying at the workplace during the last six months.ConclusionsThe experience among the professionals differs most in the Job task measurement level. The results indicate that although different OH professionals experience psychological and social factors at work in different ways, their experiences are generally satisfactory even though harassment and bullying do exist. The research about occupational health professionals and their work environment is sparse. Further applied research is needed for the planning and development of occupational health services in Sweden.

Resilient social workers’ perspective on their professional work during the COVID-19 pandemic. An interpretative phenomenological analysis

ABSTRACT This study aimed to an in-depth understanding and meaning making of the resilience processes of resilient social workers providing services during the COVID-19 pandemic, over a period of two years from the outbreak. A sample of 23 resilient social workers covering a range of different social services organisations in Romania participated in three focus groups. The method of interpretative phenomenological analysis has led to a matrix of four themes: resilience process, resilience factors, the meaning of the pandemic, the focus group experience. Findings showed that resilience processes evolved over three phases interpreted through the lenses of Bridges transitions model: firstly (March 2020–May 2020) ‘shock and chaos', secondly (June 2020–February 2021) ‘identifying order in chaos'; thirdly, (March 2021–March 2022) ‘integration and growth’. Findings indicate that individual resilience factors and team factors prevailed over organisational factors, even though supportive leadership and organisational support acted as resilience enhancers. Within a socio-ecological approach, a focus on individual resilience factors and relationships must not distract from the contribution that structural and social policy changes may have on resilience processes. Lessons learned - can contribute to the development of a resilience-informed approach to social work education and practice at both national and European level.

Environmentally sustainable health and social care – A proposal for goals and steering for Finland

Abstract Issue Health and social services cause significant environmental impacts. In Finland, national steering towards environmentally sustainable health and social care has been lacking. Description of the problem A multidisciplinary research project (EKO SOTE 2022-2023) was designed to investigate aims and steering mechanisms for environmentally sustainable social and health care in Finland. The project aimed to propose national steering and monitoring mechanisms for stronger environmental sustainability within the sector. Data for the proposal was collected from literature, review of national legislation, interviews, surveys, and co-development events. The project also aimed to calculate the carbon footprint of Finnish health and social care with the EEIO model ENVIMAT. Results It was estimated that health and social care contributed to 6.5% of Finland’s national carbon footprint in 2019, of which the share of health care was 4.2%. The new goal ‘Social and health care is carbon neutral and minimizes the environmental burden by 2035’ was proposed to be incorporated in the national strategic steering. Wellbeing service counties (WSC) as public care providers were suggested to be included as responsible actors in the Finnish Climate Act. National networks and targeted project funding for WSCs were found important. Three sets of indicators were designed for monitoring environmental sustainability: minimum indicators for all WSCs for national monitoring, voluntary indicators for regional monitoring, and indicators for advanced regions to pioneer best practices. Lessons According to the informants, national steering for environmentally sustainable health and social care is urgently needed. The national goal should be ambitious, wide-ranging, and feasible, and cover environmental aspects broadly. The steering requires multiple mechanisms: normative, strategic, informational, and economic. WSCs should be empowered to develop suitable means to achieve the national goal. Key messages • The project provided an ambitious, feasible, and comprehensive national goal and steering model for reducing the environmental impact of health and social care in Finland. • Collaborative efforts and joint steering model could advance environmental sustainability in health and social care.

Public and professional attitudes to the digitisation of health and social care in Ireland

Abstract Background The European Commission has set targets for all EU citizens to have access to electronic medical records by 2030. In Ireland the Sláintecare health reform programme has set goals around the use of digital technologies in health and social care. The Health Information and Quality Authority (an independent authority established to drive high-quality and safe care for people using health and social care services in Ireland) in partnership with the Health Service Executive (public healthcare provider) and the Department of Health (Ministry) conducted a National Engagement on Digital Health and Social Care. The aim of this engagement was to understand the opinion, attitudes and comfort levels of the public and professionals working in health and social care around digitisation of health and social care. Methods The National Engagement on Digital Health and Social Care used a mixed-method approach to data collection. There were two surveys, a national telephone survey with a representative sample of the public (n = 2009) and an online survey with professionals working in health and social care (n = 1020). There were separate focus groups with professionals and with the public, including representatives of minority groups. Results Preliminary results indicate that the public and professionals have positive attitudes to digital health and social care. Of the public surveyed 73% said that they are likely to access their online health record. Professionals feel that when the public have access to information via an online health record they will be better informed about their health (88%). Both the professionals and public feel that it is important to ensure patient choice around the format and delivery of care. Conclusions The research provides valuable insights and gives the public and professionals a platform to voice their opinions and have a meaningful impact on how digital health and social care is developed and implemented in Ireland. Key messages • This research provides unique insights and a deeper understanding into the attitudes of Irish public and professionals working in health and social care towards digital health. • Research findings will inform national policy, legislation and recommendations on the use of digital health tools in Ireland.

Enabling effective knowledge sharing through a Knowledge Hub

Abstract The objective of the THCS Knowledge Hub is to facilitate and implement effective knowledge sharing and capacity-building activities for the transformation of health and social care systems in Europe, tailored to the users’ needs and local context in order to prepare the ground for the transformation of health and social care systems. The Hub acts as personalised and interactive “matchmaking” platform which will allow the potential users to (a) access, provide and search for personalised and tailored resources generated in the THCS community but also beyond, reflecting the local maturity and conditions enabling the transformation of health and social care systems; (b) facilitate a support for the potential adaptation and transferability of these resources across the European health and social care settings through the functional use of THCS Innovation Transferability Framework; (c) enable the policy dialogue and capacity-building support for policy-makers in order to enhance their skills, knowledge and experience in health and social care transformation; (d) access and engage with THCS community of experts and ecosystems in order to maximise the access and use of the exiting knowledge and expertise for the transformation of health and social care systems; (e) signpost to existing evidence and resources related to health and social care transformation to enable effective knowledge sharing (educational webinars, peer review activities, study visits, training workshops), exchange of good practices and experience in transforming health and social care systems.

“Do not forget about us.” A systematic review of needs and unmet needs in dementia care in Europe

Abstract Background In Europe, the prevalence and costs of dementia, including Alzheimer’s disease, are rising due to demographic changes. The care provided does not adequately address the needs of stakeholders involved. This systematic review aims to identify the needs, and unmet needs in European dementia care, thus providing a comprehensive framework to improve dementia care services. Methods Our inclusion criteria, adhering to PRISMA guidelines, include studies published from 2013 to 2023, and addressing needs and unmet needs of persons living with dementia, caregivers, and dementia care professionals. Risk of bias was evaluated using the Mixed Methods Appraisal Tool. Results From an initial pool of 3738 articles, 48 studies meet inclusion criteria. Caregivers express need for support, notably in psychological and logistical assistance, in managing daily errands and healthcare tasks, and to navigate healthcare system, exacerbated by the stress and isolation during the COVID-19 pandemic. Persons living with dementia face challenges in social inclusion due to the lack of public understanding and community-based care. Dementia care professionals emphasise need for more training and resources to manage dementia effectively, with a recent shift towards the necessity for telehealth competencies. Furthermore, caregivers from ethnic minorities highlight the importance of culturally sensitive healthcare access to overcome cultural and language barriers. Conclusions Educational resources, broaden community support, clear information about available care services, and public understanding of dementia were the most commonly expressed unmet needs. Addressing these needs within the dementia care network is crucial for better service integration and improving the quality of life for all stakeholders involved. Future research should focus on developing strategies to address the unmet needs, ensuring robust support for the increasing number of individuals affected by dementia. Key messages • Care dementia effectively needs more resources, training, and a culturally sensitive healthcare access to ethnic minorities. • People living with dementia and caregivers need psychological and community-based support, social inclusion, clear information about available care services, and public understanding of dementia.

Exploring the professional discourse on environmental social work: a descriptive content analysis of selected publications from Germany and the US

Climate change and its disproportionate impacts on vulnerable groups have prompted the social work profession to become increasingly involved in environmental justice issues. Academic discourse on environmental social work has surged in the last decade, but limited studies examine its implementation by practitioners or information dissemination by professional organisations. Translational research highlights the crucial role of professional associations in informing practitioners of new scientific discoveries and practice paradigms. This qualitative content analysis compares a small selection of articles and podcast episodes published through the professional associations of social workers in the US (the National Association of Social Workers) and Germany (the Deutscher Berufsverband für Soziale Arbeit e.V.), respectively, focusing on environmental social work and its implications for the social work profession. The findings suggest that publications from both countries use similar arguments for proving the relevance of climate change issues for the profession but diverge considerably in their focus on how environmental social work should be applied.