Social Work Input Research Articles

Screening, investigation and follow-up of neonates with small for gestational age in a metropolitan hospital in Australia-observational retrospective study.

Infants with small for gestational age (SGA) have an increased risk of short and long-term health outcomes, with potentially modifiable risk factors. This study aims to determine the prenatal risk factors associated SGA and evaluate the clinical management of affected infants. An observational retrospective study of medical records of infants born at Nepean Hospital and discharged with a diagnosis of SGA over 5 years (1st January 2015 to 31st December 2019). Data included demographic details, antenatal care, maternal risk factors and clinical management of the infants. Six hundred and seven infants had a discharge diagnosis of SGA, from 20,392 infants born. Of the 607 infants identified, 487 (80%) had SGA, 97 (16%) had asymmetrical SGA, 175 (29%) had symmetrical SGA, and 50 (8%) were incorrectly diagnosed with SGA based on growth measurements taken at birth. The most prevalent maternal risk factors were the presence of chronic disease (n=402, 66.23%), current smoking (n=159, 26.19%), social work input (n=108, 17.79%), gestational diabetes mellitus (n=96, 15.82%) and Aboriginal background (n=73, 12.03%). Prenatal genetic testing was conducted in 89.62% (n=544); 58.81% (n=357) had placental abnormalities; 36.57% (n=222) were recommended follow-up with a general practitioner (GP) and paediatrician, and 21.09% (n=128) were recommended a combination of midwifery in the home (MITH), GP, and paediatric follow-up. Two infants were recorded with no follow-up. Diagnostic inaccuracies were found in infants with SGA. More intensive antenatal care for women with risk factors for SGA might improve the health of those with chronic disease; support for smoking cessation could also be offered.

Social work practice with self-neglect and homelessness: Findings from vignette-based interviews

Abstract This article reports social workers’ attitudes and approaches to working with people experiencing multiple exclusion homelessness (MEH) who self-neglect, and whether these people receive services, including safeguarding, differently from other populations. It draws on telephone interviews in 2020 with twenty-two social workers working with adults in a range of statutory local authority and National Health Service hospital roles in England. Interviews used two almost identical vignettes featuring self-neglect to prompt discussion and solicit experiences; one included homelessness and drug use to draw out any differences. Following transcription, interview data were analysed thematically. What emerged is a rich understanding of practice responses to self-neglect, but also uncertainties within contemporary social work: whether people who are homeless fall under the ‘umbrella’ of Adult Social Care and safeguarding; and whether self-neglect ‘fits’ under safeguarding. Additionally, participants described barriers to successful multi-agency support for people experiencing MEH, including stigma and exclusion from some statutory services. There was evidence that recent learning from Safeguarding Adults Reviews and local deaths has led to some examples of stronger multi-agency working in this context. The findings suggest more clarity is needed within the profession to ensure that people experiencing MEH benefit from strengthened social work input and safeguarding expertise.

“It’s Just Too Much”: The Financial Calculus in Medicare Hospice

There is extensive literature on the significance of financial incentives in the Hospice Medicare Benefit (HMB) and the growth of proprietary ownership of hospices in the United States. A literature review indicates a paucity of information on hospice nurses’ and hospice social workers’ perceptions of the impact of the HMB’s financial structure on care planning and delivery decisions. In a previous issue of this journal, the author addressed the literature gap by presenting a study on hospice nurses’ perceptions of the impact of financial factors on their decision-making regarding care for Medicare hospice beneficiaries. The study presented in this article is a companion qualitative study to the nurses’ study. This article presents background on the topic and an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 37 hospice social workers from 6 different hospices between December 1, 2018 and January 31, 2020, in the New York City metropolitan area. Six themes emerged from the interviews: finances are the guiding principle in care planning and service delivery decisions; balancing patient care needs, cost, and finance-related length of stay (LOS) is a challenge; the emphasis on finance diminishes the social workers’ ability to address hospice patient needs; the emphasis on finance diminishes the social workers’ ability to address hospice caregiver needs; the social work role is diminished because of the role of nurses in developing and implementing the plan of treatment, which influences finances; and the Interdisciplinary Team (IDT) is the crucial clinical and financial decision-making setting, but gives limited weight to social work input.

On Solving the Problem of Mental Health Care with the Social Work Input

In difficult conditions of the external military aggression and aggravated internal political and social problems in Ukraine, the level of mental health disorders is growing, thus encouraging social change. Purpose. The study aims to identify possibilities and ways of bringing in social work in solving the problem of mental health care in Ukraine. Design/Methodology Approach. Theoretical research methods were used to find out opinions of experts, including persons with mental illness, on the challenges and needs of the mentally disabled in Ukraine. Qualitative content analysis of the narrative interviews with clients of the social organization and expert interviews was done to identify opportunities for involving social workers by the example of Lviv. Results. The study reveals the retrospective and explores the current state of addressing the problem of mental health care in Ukraine. It offers the problem solution based on attracting social work. Limitations and strengths of the study. The difficult times Ukraine is going through complicate the introduction of innovations in the social sphere, health care and education. This, however, stimulates change to improve its citizens’ well-being and health. Practical/Social Value. The initiative to train social workers for professional activity in mental health care supports the population health improvement. Originality/Conclusions. The findings show the need for the social work input in mental health care in Ukraine. The social work education is addressing the need, also involving a community health clinic

Identifying unmet needs in long-term stroke care using in-depth assessment and the Post-Stroke Checklist - The Managing Aftercare for Stroke (MAS-I) study.

Detailed data on the long-term consequences and treatment of stroke are scarce. We aimed to assess the needs and disease burden of community-dwelling stroke patients and their carers and to compare their treatment to evidence-based guidelines by a stroke neurologist. We invited long-term stroke patients from two previous acute clinical studies (n = 516) in Berlin, Germany to participate in an observational, cross-sectional study. Participants underwent a comprehensive interview and examination using the Post-Stroke Checklist and validated standard measures of: self-reported needs, quality of life, overall outcome, spasticity, pain, aphasia, cognition, depression, secondary prevention, social needs and caregiver burden. Fifty-seven participants (median initial National Institutes of Health Stroke Scale score 10 interquartile range 4-12.75) consented to assessment (median 41 months (interquartile range 36-50) after stroke. Modified Rankin Scale was 2 (median; interquartile range 1-3), EuroQoL index value was 0.81 (median; interquartile range 0.70-1.00). The frequencies for disabilities in the major domains were: spasticity 35%; cognition 61%; depression 20%; medication non-compliance 14%. Spasticity (p = 0.008) and social needs (p < 0.001) had the strongest impact on quality of life. The corresponding items in the Post-Stroke Checklist were predictive for low mood (p < 0.001), impaired cognition (p = 0.015), social needs (p = 0.005) and caregiver burden (p = 0.031). In the comprehensive interview, we identified the following needs: medical review (30%), optimization of pharmacotherapy (18%), outpatient therapy (47%) and social work input (33%). These results suggest significant unmet needs and gaps in health and social care in long-term stroke patients. Further research to develop a comprehensive model for managing stroke aftercare is warranted.Clinical Trial Registration: clinicaltrials.gov NCT02320994.

Optimising the Comprehensive Geriatric Assessment

Introduction: Carew House Day Hospital is an outpatient assessment unit for patients aged 65 years and over and is operated by the Medicine for the Elderly service in St. Vincent’s University Hospital (SVUH). Patients attending Carew House undergo multidisciplinary Comprehensive Geriatric Assessment (Medical, Nursing, Physiotherapy, Occupational Therapy and Social Work) with further access to Speech and Language Therapy, Dietician and Smoking Cessation services as required. The service assesses approximately 600 new patients annually. The National Clinical Programme for Older People advocates a Comprehensive Geriatric Assessment (CGA) of frail older patients as a means to increase independence in the home and reduce inappropriate admissions to nursing homes. Short Description of Practice Change Implemented: Deficiencies in the CGA were identified and discussed at a meeting of the Day Hospital Management involving medical, nursing and allied health staff. These deficits were demonstrated through an initial pilot and retrospective review of patients assessed in the Day Hospital. It was recognised that additional resources and staff for the Day Hospital would not be an available option to alleviate this problem. Once deficits in the CGA were identified and outlined, staff were empowered to engage with the change process immediately in order to develop improvement solutions. Aim and Theory of Change: The aim of this project was to empower members of the multidisciplinary team (MDT) to generate efficiencies within the service and to identify areas where the CGA could be streamlined. In December 2014, the following interventions were implemented: A new vetting process for patient referrals to ensure appropriate MDT members would be available on the date of assessment Nomination of designated nurse leader and senior clinician in the absence of regular staff An additional and timely referral pathway for physiotherapy and occupational therapy assessment using pre-existing additional community services Alternative access routes for medical social work input involving redesign of the referral pathway Targeted Population and Stakeholders: This included all patients assessed in Carew House Day Hopsital and all members of the MDT. Timeline: September 2014 - April 2015 Highlights: Having a Consultant’s clinical opinion directly available for each patient increased from 79% to 88%. The presence and input of a Nurse Manager on the day of assessment increased from 30% to 99%. Completion of Physiotherapy and Occupational Therapy assessment for patients increased from 65% to 73%, and 96% to 99% respectively. In addition to these improvements in the CGA, systems were implemented to ensure that a senior clinical opinion (Registrar or Consultant) was available at all times via telephone and a Deputy Nurse Lead was appointed in the absence of a Nurse Manager. An additional 15% of patients received Physiotherapy assessment via the newly implemented alternative referral pathway. Comments on Sustainability: It is recognised that while this suite of interventions has resulted in progress, our service is in constant need of review and regeneration in order to continue to improve for our patients. Comments on Transferability: This change process engaged staff across the MDT and highlighted that positive change in a service is achievable through improving efficiency and redesigning processes, without budgetary expansion. This model is transferable. Conclusions: Changes in Carew House Day Hospital resulted in improvements in the constituents and overall quality of the CGA for our catchment community. Discussions: While this project resulted in some improvement, the main barrier encountered was in recognising the deficits in our service that required change. Lessons Learned: Resource limitations should never stand in the way of improvement!

The Mediational Role of Relational Psychological Contract in Belief in a Zero-Sum Game and Work Input Attitude Dependency

Abstract The purpose of this study was to investigate the mediational role of relational psychological contract in social beliefs and work input attitude dependency. We analyzed data taken from employees (N = 258) in four different organizations operating in the Pomeranian market. A mediation analysis showed a strongly mediating role of psychological contract in the negative relationship between perception of life as a zero-sum game (BZSG) and work input. The motivational effect of the relational psychological contract, that is the role of job security, interesting work, a career in the company, opportunities for promotion and other HRM practices prevail over the significance of personal beliefs, especially when these are negative. If the company lacks the appropriate HRM systems then day-to-day social exchanges can be crucial in modifying the social beliefs of the employee.

P30 Feasibility of a New Out-Patient Breathlessness Support Service

BackgroundBreathlessness is a common and devastating symptom affecting many patients with advanced malignant and non-malignant disease. Management comprises non-pharmacological and pharmacological interventions best delivered by a multidisciplinary group.AimTo describe the...

Psychological support for parents in UK tertiary-level neonatal units—a postcode lottery

<h3>Background and Aim</h3> Neonatal intensive care units (NICUs) are high stress environments for parents and staff. A high prevalence of post-traumatic stress in parents exists, often persisting for years. Maternal anxiety affects infant cognitive and socio-emotional development assessed at 24 months corrected age. The authors aimed to assess current psychological and social support available for parents in UK tertiary-level NICUs. <h3>Methods</h3> Telephone survey in August 2009 of all 50 tertiary-level NICUs in the UK. The authors asked the senior nurse/nurse manager what formal psychological support, if any, was provided to parents on their NICU, and whether their unit had dedicated social work input. <h3>Results</h3> The authors obtained information from all 50 (100%) units. Two units (4%) had dedicated clinical psychologists for their NICU who provided comprehensive support for parents and offered regular meetings and counselling sessions; a further 15 units (30%) had the support of an available clinical psychologist who provided input to both the NICU and maternity unit as required; 13 units (26%) offered some psychological support, though not from a trained psychologist (eg, offered by a trained counsellor nurse/family care nurse, a parental support group, bereavement counsellor or hospital chaplain); in 20 (40%) units no psychological support was available for parents. Regarding social work support for the NICU, 20 (40%) units had regular input from a social worker, either in terms of them joining the clinical ward round or attending a weekly psychosocial meeting. Time allocated for the dedicated social worker support ranged from a few hours per week to a full time social worker based in the unit. Five (10%) units held a weekly social ward round. The majority of NICUs (30/50; 60%) did not have either a dedicated social worker, or any regular meeting between nurses/doctors and social worker to discuss the social needs of parents/families. <h3>Conclusion</h3> Some NICUs offer parents excellent psychological support, while many other NICUs offer parents no formal psychological support whatsoever. The psychological and social needs of many parents with babies on UK neonatal units are presently not being addressed, and this may have adverse long-term consequences for infants and their families.

A Major Role for Social Work Input during Development of an Innovative Post-Baccalaureate Research Education Program in a Medical Center Environment

The Post-Baccalaureate Research Education Program (PREP) at Mount Sinai School of Medicine targets participants from groups that are underrepresented in biomedical research careers. During its first 5 years, Mount Sinai PREP has sent over 70% of the PREP scholars to an excellent array of PhD or MD/PhD programs. Over 90% of those students are progressing well in their doctoral studies and report important contributions of PREP to their success. Social work and educational psychology principles inform strategies used to identify and address gaps or impediments that would otherwise diminish the potential of Mount Sinai PREP scholars to succeed in cutting-edge research careers.

Mutual Aid among Young People with Emotional and Behavioral Problems: A Proposed Theoretical Framework

ABSTRACT Among young people with emotional and behavioral problems, mutual aid is likely to be of valuable assistance in their rehabilitation, and be deserving of social work support. The benefits of mutual aid stem from the possibility that it prolongs the effect of the contribution of social work services. Given the potential benefits of mutual aid, it is imperative to clarify ways for social work services to maximize these benefits. This paper reviews the existing literature on mutual aid among young people with emotional and behavioral problems. In so doing, we seek to develop a theoretical framework that encompasses key factors conducive to the mutual aid and rehabilitation of this population. These factors include the type of aid, specificity of aid, and balanced coordination in social work input to young people's mutual aid. In particular, balanced coordination requires the social worker not to make excessive intervention in the mutual aid group and thus encourages an optimal use of resources.

94 Palliative Care Social Worker: A Pilot Post to Establish the Role

A pilot post was funded to determine the role of a palliative care social worker in North Hampshire. Unusually, there had previously been no social work input to the North Hampshire Palliative Care Service (NHPCS). NHPCS consists of a hospital and community team, based in the Basingstoke and North Hampshire Hospital (BNHFT) and St Michael’s Hospice on the hospital site.

Child care social work and the role of state employees

Provision of statutory social work services to children and their families has a long and contentious history as conflicting ideas about appropriate interventions, in what is still largely characterized as the private sphere of the family, define the terrain for practice. More recently, staff in social services departments have had to meet the challenges of contemporary practice at a time of major restructuring. Implementing the National Health Service &amp; Community Care Act 1990, and meeting the demands of Audit/Social Services Inspectors, leaves departments struggling to meet externally imposed criteria focused on particular interpretations of the nature of economy, efficiency and effectiveness in the public sector. In general staff have had to respond to competing imperatives as they offer services in ways that reflect shifting priorities, priorities that are inevitably shaped by ideological, political, economic and technological agendas as well as by professional concerns. In the process the role and task for social work is once again being redefined. This paper seeks to challenge dominant narratives, through exploration of the contemporary context for practice, and reassert the importance of social work input even as individuals’ working lives change around them.

Effect of community based management in failure to thrive: randomised controlled trial

Objective : To evaluate the effectiveness of a health visitor led intervention for failure to thrive in children under 2 years old.Design : Controlled trial, randomised by primary care practice.Setting...

SOCIAL WORK WITH THE ADDICTIONS – CAN THE PROFESSION DELIVER?

This paper reviews the way in which the problems of drug addiction have been managed in Hong Kong. Given the lip service paid so far to social work input in the drug rehabilitation scene, an argument is made for an expansion of the role of social work. But it is contended that social work will only be relevant if addiction work is placed squarely within the totality of an individual's life functioning, the area of concern to social work. This would entail, however, a reconceptualisation of addiction from that of the prevailing medical view, which sees it as a disease process, to that of seeing addiction as a cognitive choice. 本文回顾香港之戒毒治疗及康复工作，发现社会工作之参予未如理想，原因乃由於滥用药物问题一直被定义为一种病态，因而治疗工作倚重於医疗界之服务。但研究指出滥用药物实应视为应付生活之惯性行为。重新定义滥用药物问题後，社会工作之介入变 为极适当，极需扩张。

A pilot study to examine the potential impact of professional social work input into a chronic spinal clinic

The potential impact of professional social work input in patients attending a tertiary neurosurgical chronic spinal clinic was assessed over a period of one year. Two hundred and sixty-four patients were booked into the clinic, and 206 attended (78%). Of these, 93 follow-up patients were selected at random and were interviewed (45%). Forty-two (45%) were male and 51 (55%) female. The median age was 50. Advice was found wanting in 35%. At follow-up (6-18 months later), 76% of those receiving it had acted successfully upon the advice given. In addition to identifying the extent of need, a simple scheme to allow easy identification of the most needy group was tested. Lack of employment was the most significant predictor of need, though a larger and more detailed study is required to assess other factors.