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Closing the empathy gap in health care: Connection First - before "intake". 缩小医疗保健中的同理心差距:在“接受”之前先建立联系。
IF 2.2 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2023-12-01 DOI: 10.1080/00981389.2023.2278787
Jean E Balestrery

In this article, a communication framework of Connection First is presented to help close the empathy gap in mainstream health care, including palliative and end-of-life care. Expanding beyond biomedicine, Connection First involves rethinking and restructuring business-as-usual in health care. It shifts the typical transactional process during the initial intake session into one that is transformational. Connection First is a structural intervention and skillset comprised of the following elements: disrupting diagnosis, humanizing history, and repairing ruptures. These elements combine to help close the empathy gap in health care during the initial clinical encounter, before intake, and improve outcomes.

在这篇文章中,提出了一个沟通框架连接第一,以缩小移情差距的主流医疗保健,包括姑息治疗和临终关怀。在扩展到生物医学以外的领域,“连接第一”涉及到对医疗照旧业务的重新思考和重组。它将初始接收会话期间的典型事务性流程转换为转换流程。连接第一是一种结构性干预和技能组合,包括以下要素:颠覆性诊断、人性化历史和修复破裂。这些因素结合起来,在最初的临床接触期间,在入院之前,缩小卫生保健方面的移情差距,并改善结果。
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引用次数: 0
Humanizing medicine: a patient perspective. 人性化医疗:患者视角。
IF 2.2 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2024-03-24 DOI: 10.1080/00981389.2024.2333744
Julie N Evanson

The purpose of this research was to explore patients' shared perceptions of what makes them feel valued and devalued during in-patient and out-patient medical visits and patients' recommendations for increasing feelings of value. A criterion-based snowball sampling method was used to recruit participants who are adults living in Anchorage, Alaska, and have had an in-patient or out-patient medical visit within at least the past year. Semi-structured qualitative interviews were conducted using eight open-ended questions via Zoom web conferencing. Data were stored and managed electronically. A thematic analysis approach guided data analysis. A phenomenological approach was applied to capture participants' shared experiences. This study's key findings highlight a shared patient perception that communication is paramount in conveying value: conversations with healthcare providers instill value, feeling valued is essential to well-being, feeling devalued is driven by depersonalization, and devaluation perpetuates discontinuity in healthcare.

本研究的目的是探究患者在住院和门诊就医期间对什么会让他们感到被重视和被贬低的共同看法,以及患者对提高价值感的建议。研究采用基于标准的滚雪球式抽样方法,招募居住在阿拉斯加州安克雷奇市、至少在过去一年内接受过住院或门诊就医的成年人作为参与者。通过 Zoom 网络会议使用八个开放式问题进行了半结构化定性访谈。数据以电子方式存储和管理。数据分析以主题分析法为指导。采用现象学方法捕捉参与者的共同经历。本研究的主要发现强调了患者的共同看法,即沟通在传递价值方面至关重要:与医疗服务提供者的对话可灌输价值,感觉被重视对健康至关重要,感觉被贬低是由人格解体驱动的,而贬低则使医疗服务的不连续性永久化。
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引用次数: 0
Delineation of core roles of oncology social workers in inpatient settings: a secondary data analysis. 住院环境中肿瘤社工核心角色的界定:二手数据分析。
IF 2.1 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2024-09-23 DOI: 10.1080/00981389.2024.2400880
Karlynn BrintzenhofeSzoc, Ting Guan, Alyssa Middleton, Shirley Otis-Green, Tara Schpamire, Makeeta Rayton, Krista Nelson, Michael L Grignon, Brad Zebrack

There is limited literature on the roles and tasks conducted by oncology social workers (OSW) who work with cancer patients in inpatient units. The purpose of this study was to delineate the roles reported to be significant to practice among OSWs who practice in inpatient settings and to identify the domains into which these roles fall. The data used in this secondary data analysis were collected in a large national study of OSWs to delineate the roles and tasks across all cancer settings. The sample extracted for this study were 240 OSWs who endorsed providing direct care to cancer patients in inpatient settings. Exploratory factor analysis revealed eight factors made up of 34 tasks. The roles were aligned with three of the four service areas in the Association of Oncology Social Scope of Practice and seven of the nine competencies set forth by the Council of Social Work Education. The findings can be used to enhance communications about the roles of inpatient OSWs across OSW constituencies, increase awareness of the role supervision and consultation to ensure equitable and just practice, enhance social work coursework to prepare students to work in healthcare inpatient settings, and in future research.

关于在住院部为癌症患者提供服务的肿瘤社工(OSW)的角色和任务的文献十分有限。本研究的目的是对在住院环境中工作的肿瘤社工所扮演的重要角色进行界定,并确定这些角色的所属领域。这项二手数据分析所使用的数据是在一项大型全国性 OSWs 研究中收集的,目的是界定所有癌症环境中的角色和任务。本研究抽取的样本为 240 名 OSW,他们认可为住院环境中的癌症患者提供直接护理。探索性因子分析揭示了由 34 项任务组成的 8 个因子。这些角色与肿瘤社会实践范围协会(Association of Oncology Social Scope of Practice)规定的四个服务领域中的三个以及社会工作教育委员会(Council of Social Work Education)规定的九项能力中的七项相一致。这些研究结果可用于加强住院患者社会工作者在社会工作者群体中的角色沟通,提高对督导和咨询角色的认识,以确保公平公正的实践,加强社会工作课程,为学生在医疗住院环境中工作做好准备,以及用于未来的研究。
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引用次数: 0
The practice of pregnancy options counseling in social service and healthcare settings in the United States: a systematic literature review. 美国社会服务和医疗机构中的怀孕选择咨询实践:系统文献综述。
IF 2.1 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2024-01-30 DOI: 10.1080/00981389.2024.2304016
Jennifer C Hollenberger, Elissa E Madden

Introduction: The purpose of this systematic literature was to summarize the literature on pregnancy options counseling for women and patients who experience an unintended pregnancy across healthcare and social service settings.

Methods: We conducted a systematic literature review using the PRISMA Checklist. Following the literature search of 8 electronic databases, we used a three-stage search process to screen articles for inclusion.

Results: A total of 20 peer-reviewed articles met the inclusion criteria for this study. Half (n = 10) of the articles reviewed were empirical studies utilizing quantitative or qualitative methodology while the other half (n = 10) were conceptual or non-empirical. The articles affirmed a shared definition of pregnancy options counseling, but terminology differences were noted over time. Lastly, variations of intervention practices appeared across practice settings, with referral practice variations being the most notable.

Conclusion: Pregnancy options counseling practices varied across settings, suggesting patients who received this intervention may not have accessed equitable or ethical care.

导言:本系统性文献旨在总结在医疗保健和社会服务机构中为意外怀孕妇女和患者提供怀孕选择咨询的文献:我们采用 PRISMA 核对表进行了系统性文献综述。在对 8 个电子数据库进行文献检索后,我们采用了三阶段检索流程来筛选纳入文章:共有 20 篇经同行评审的文章符合本研究的纳入标准。其中一半(10 篇)是采用定量或定性方法进行的实证研究,另一半(10 篇)是概念研究或非实证研究。这些文章肯定了怀孕选择咨询的共同定义,但也注意到了不同时期的术语差异。最后,在不同的实践环境中,干预措施也存在差异,其中转介实践的差异最为显著:妊娠选择咨询在不同的实践环境中存在差异,这表明接受这种干预的患者可能无法获得公平或道德的医疗服务。
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引用次数: 0
Mothers' choice of health management services for under-five children with common illnesses: evaluating social workers' impact in Nigerian health sector. 母亲对五岁以下常见病儿童健康管理服务的选择:评估社会工作者在尼日利亚卫生部门的影响。
IF 2.1 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2024-07-26 DOI: 10.1080/00981389.2024.2382160
Jacinta Ene, Samuel Ebimgbo, Chinyere Onalu, Paulinus Okah, Prince Chiagozie Ekoh, Agha A Agha

Introduction: Every child deserves the right to life. In Nigeria like other African countries, a high burden of child mortality prevails. Attaining a low-mortality rate of children entails that mothers who are the primary caregivers are in the best position to provide quality healthcare management.

Method: With the phenomenological approach in qualitative research, the researchers sourced data using Focus Group Discussions (FGDs) and In-Depth Interviews (IDI) from 38 mothers of various categories. The participants were purposively selected from four government and mission health institutions in a semi-urban Nsukka town, Enugu State. Data were analyzed thematically.

Findings: Results revealed that mothers utilize health institutions including government, mission, private, pharmacies and patent medicine vendors when seeking healthcare for their children. Their inability to recognize potential life-threatening conditions is the leading factor in increasing child mortality. Findings show that because participants were concerned about financial challenges; they were ready to adopt traditional medicine as an alternative to modern medicine. The study showed evidence of unsafe strategies mothers adopt for the health management of their under-five children with common illnesses. Participants indicated little knowledge of social workers' engagement in health institutions.

Conclusion: Healthy living is essential in the protection from illnesses. Since under-five children are vulnerable to illnesses, their mothers should provide them with quality healthcare management. The study recommends that social workers' engagement with health providers and users in semi-urban societies could help propagate healthcare awareness and strategies in mothers' choice of health management for under-five children in Nigeria. Overall, adequate health policy consideration should be given to all under-five children in Nigeria.

导言:每个儿童都应享有生命权。尼日利亚和其他非洲国家一样,儿童死亡率居高不下。要降低儿童死亡率,作为主要照顾者的母亲就必须提供高质量的医疗保健管理:研究人员采用定性研究中的现象学方法,通过焦点小组讨论(FGDs)和深入访谈(IDI)从 38 位不同类别的母亲中获取数据。研究人员从埃努古州恩苏卡市半城区的四家政府和教会医疗机构有目的地挑选了参与者。对数据进行了专题分析:结果显示,母亲们在为孩子寻求医疗保健服务时,会利用包括政府、教会、私人、药房和中成药商贩在内的医疗机构。她们无法识别潜在的危及生命的病症是导致儿童死亡率上升的主要因素。研究结果表明,由于参与者担心经济困难,她们准备采用传统医学来替代现代医学。研究显示,有证据表明,母亲在对患有常见病的五岁以下儿童进行健康管理时采取了不安全的策略。参与者对社工参与医疗机构的情况知之甚少:结论:健康的生活对预防疾病至关重要。由于五岁以下儿童容易生病,他们的母亲应为他们提供优质的医疗保健管理。研究建议,社会工作者与半城市社会中的医疗服务提供者和使用者接触,有助于在尼日利亚母亲选择五岁以下儿童健康管理时宣传医疗保健意识和策略。总之,应充分考虑尼日利亚所有五岁以下儿童的保健政策。
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引用次数: 0
Centering persons who use drugs: addressing social determinants of health among patients hospitalized with substance use disorders. 以吸毒者为中心:解决因药物使用障碍住院患者健康的社会决定因素。
IF 2.2 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2023-12-01 DOI: 10.1080/00981389.2023.2278777
Kate Roberts, Emily Smith, Cindy Sousa, J Elaina Young, Anna Grace Corley, Darin Szczotka, Abby Sepanski, Ashley Hartoch

Social workers have emerged as leaders within Addiction Consult Services (ACS) due to their ability to provide a wide range of services, from crisis work and brief therapeutic interventions to connecting patients to community resources. Many hospitals have implemented ACS to address the overdose crisis and the sharp rise in drug use-related infections, including skin and soft tissue infections, osteomyelitis, and endocarditis; a result of unaddressed systemic social determinants of health (SDOH). Yet, despite social workers being at the forefront of inpatient substance use work, little guidance exists regarding social work's role in leading person-centered addiction care and addressing SDOH in the hospital setting. The authors of this paper are licensed clinical social workers who have worked across five different health systems, engaging persons who use drugs (PWUD) in the context of an ACS. This paper examines five practice interventions of social work practice within hospitals that represent key points for innovation. Drawing on social work's unique commitments to social justice, strengths, and person-in-environment, these interventions operate within eco-social approaches to help us grapple more effectively with ways that health - and disease - are socially and economically produced by multiple interacting factors. We provide a clinical roadmap of interventions for social workers in hospital settings with PWUD to demonstrate how social work leadership within inpatient care models can help us better address the impacts of various intersecting SDOH on the care of PWUD.

社会工作者已经成为成瘾咨询服务(ACS)的领导者,因为他们有能力提供广泛的服务,从危机工作和短暂的治疗干预到将患者与社区资源联系起来。许多医院已经实施ACS,以解决药物过量危机和药物使用相关感染的急剧上升,包括皮肤和软组织感染、骨髓炎和心内膜炎;未解决的系统性健康社会决定因素(SDOH)的结果。然而,尽管社会工作者站在住院药物使用工作的最前线,但关于社会工作者在领导以人为中心的成瘾护理和解决医院环境中的SDOH方面的作用,几乎没有指导。这篇论文的作者是有执照的临床社会工作者,他们在五个不同的卫生系统中工作,与ACS患者接触。本文考察了医院社会工作实践的五种实践干预措施,这些干预措施是创新的关键。这些干预措施利用社会工作对社会正义、力量和环境中的人的独特承诺,在生态社会方法中运作,帮助我们更有效地应对健康和疾病是由多种相互作用因素在社会和经济上产生的。我们为患有PWUD的医院环境中的社会工作者提供了干预的临床路线图,以展示住院护理模式中的社会工作领导力如何帮助我们更好地解决各种交叉SDOH对PWUD护理的影响。
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引用次数: 0
Addressing substance use disorder in a hospital prenatal setting. 在医院产前环境中应对药物使用障碍。
IF 2.2 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2024-02-19 DOI: 10.1080/00981389.2024.2316695
Laudy Burgos, Michelle Gelband

Pregnancy can be a time of joy and hope but, for birthing parents struggling with a substance use disorder (SUD), it can be challenging. Social stigma, shame, and the potential legal ramifications present barriers to individuals seeking the care they need. Marginalized groups, in particular, face challenges that put them at even greater risk for substance misuse. Substance use during pregnancy can further impair the individual's level of functioning, and it has also been associated with problems in the social, emotional, and cognitive development of their children. Pregnancy and addiction each require guidance and good medical care. By integrating substance misuse treatment services under the umbrella of their medical care, clinics facilitate timely access to care, as well as help break the stigma associated with substance misuse. Our program offers a comprehensive and multidisciplinary approach to support pregnant individuals with SUDs. Interventions include support, education, case management, and mental health counseling. By providing optimal prenatal care early on, individuals can receive the treatment that they need so that they can achieve physical and emotional stability once the baby arrives, which ultimately has better outcomes for the parent and child's health and wellbeing.

怀孕可以是一个充满喜悦和希望的时刻,但对于患有药物使用障碍 (SUD) 的生育父母来说,这可能是一个挑战。社会污名化、羞耻感以及潜在的法律后果都是个人寻求所需护理的障碍。特别是边缘群体,他们面临的挑战使他们面临更大的药物滥用风险。怀孕期间使用药物会进一步损害个人的机能水平,而且还与其子女的社交、情感和认知发展问题有关。怀孕和毒瘾都需要指导和良好的医疗护理。通过将药物滥用治疗服务纳入医疗护理的范畴,诊所可以帮助患者及时获得护理,并有助于打破与药物滥用相关的耻辱感。我们的计划提供全面的多学科方法,为患有药物滥用的孕妇提供支持。干预措施包括支持、教育、个案管理和心理健康咨询。通过尽早提供最佳产前护理,孕妇可以获得所需的治疗,从而在宝宝出生后获得身体和情绪上的稳定,最终为父母和孩子的健康和幸福带来更好的结果。
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引用次数: 0
Behavioral health treatment delivery by social workers in accountable care organizations. 责任医疗组织中社工提供的行为健康治疗。
IF 2.1 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2024-11-22 DOI: 10.1080/00981389.2024.2427750
Chris Miller-Rosales, Ellen Meara, James Murphey, Abhirupa Dasgupta, Terri Lewinson

Nearly half of Traditional Medicare beneficiaries receive their care through an Accountable Care Organization (ACO), in which provider groups are subject to healthcare cost and quality benchmarks for a defined patient population. Although the skills of the social work profession align with the goals of these contracts (coordination of service needs across multiple health and social care settings), there is little information on social worker inclusion as behavioral health providers in ACOs. We developed and administered a national survey of organizations (n = 227) with Medicare and Medicaid ACO contracts to provide an estimate of the percentage of ACOs that reported social worker-delivered behavioral health treatment. Approximately half of the respondents reported that social workers delivered mental health treatment, while a third reported that social workers delivered substance use treatment. Organizations that included specialty mental health treatment facilities were more likely to report social worker-delivered mental health and substance use treatment. Organizations that included rural healthcare facilities were less likely to report social worker-delivered substance use treatment. By describing the prevalence and predictors of social worker-delivered behavioral health treatment in ACOs, this study contributes foundational estimates for future research on the role of this important workforce in ACOs.

近一半的传统医疗保险受益人通过 "责任医疗组织"(ACO)接受医疗服务,在该组织中,医疗服务提供者团体必须遵守针对特定患者群体的医疗成本和质量基准。虽然社会工作专业的技能符合这些合同的目标(协调多种医疗和社会护理环境的服务需求),但有关社会工作者作为行为健康服务提供者加入 ACO 的信息却很少。我们对签订了医疗保险和医疗补助 ACO 合同的机构(n = 227)进行了一项全国性调查,以估算出报告由社工提供行为健康治疗的 ACO 所占的比例。大约一半的受访者称社工提供心理健康治疗,三分之一的受访者称社工提供药物使用治疗。包括专业心理健康治疗机构的组织更有可能报告由社工提供心理健康和药物使用治疗。而包含农村医疗机构的组织则较少报告由社工提供药物使用治疗。通过描述 ACO 中由社工提供行为健康治疗的普遍性和预测因素,本研究为今后研究这一重要劳动力在 ACO 中的作用提供了基础性的估计。
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引用次数: 0
Spiritual Intelligence: A Vital Component of Consolation within Rehabilitation for Medical Social Workers. 精神智力:医务社会工作者康复安慰的重要组成部分。
IF 2.1 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2024-12-03 DOI: 10.1080/00981389.2024.2425611
Håkan Nilsson

This article aims to provide medical social workers with a discourse highlighting eight attributes within spiritual intelligence that may be drawn on to comfort persons with disability. This strengthens the medical social workers capacity to offer genuine solace through the disabled person's rehabilitation process. The attributes are holisticness, authenticity, trustworthiness, intentionality, ethical-mindedness, compassion, empathy, and present-centeredness, which will be described in turn. Within these discourses, the paper draws upon Frankl's logotherapy, Maslow's Hierarchy of Needs, Buber's dialogue philosophy, and the influence of mindfulness thought in relation to spiritual intelligence. These can all help medical social workers personally apply the eight attributes. This discourse is particularly relevant for medical social workers, as they dedicate their professional lives to helping persons with disabilities through their rehabilitation process.

本文旨在为医务社会工作者提供一个话语,强调精神智力中的八个属性,可以用来安慰残疾人。这加强了医务社会工作者在残疾人康复过程中提供真正安慰的能力。这些属性是整体性、真实性、可信赖性、意向性、道德意识、同情心、同理心和以现在为中心,这些将依次描述。在这些话语中,本文借鉴了弗兰克尔的意义疗法、马斯洛的需求层次、布伯的对话哲学,以及正念思想对精神智力的影响。这些都可以帮助医务社会工作者个人运用八种属性。这一论述与医务社会工作者特别相关,因为他们的职业生涯致力于帮助残疾人完成康复过程。
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引用次数: 0
Who is behind the robot? The role of public social workers in implementing robotic eldercare program in South Korea. 机器人背后是谁?韩国公共社工在实施机器人养老项目中的作用。
IF 2.2 4区 社会学 Q1 SOCIAL WORK Pub Date : 2024-01-01 Epub Date: 2024-03-06 DOI: 10.1080/00981389.2024.2324849
Heesun Shin, Othelia EunKyoung Lee

A companion robot named Hyodol is a digital technology implemented for eldercare in South Korea. Drawing insights from semi-structured interviews with public social workers actively involved in the Hyodol care program, this study explores how social workers contribute to the success of the robotic care program. Throughout the phases of selecting potential users, introducing older adults to the robot, and maintaining the robotic program, the practical wisdom of social workers plays an important role. Despite the increased workload in case management and the emotional labor associated with navigating the care system, these pioneering social workers maintained high morale to adopt the robotic care system. By shedding light on the specific roles of social workers, this study contributes to a deeper understanding of the intricate dynamics that underlie successful robotic eldercare.

在韩国,一种名为 "Hyodol "的陪伴机器人是一种用于老年人护理的数字技术。本研究通过对积极参与 Hyodol 护理项目的公共社会工作者进行半结构式访谈,探讨了社会工作者如何为机器人护理项目的成功做出贡献。在选择潜在用户、向老年人介绍机器人以及维护机器人项目的整个阶段,社会工作者的实践智慧发挥了重要作用。尽管个案管理的工作量增加,而且在护理系统中还要付出情感劳动,但这些先驱社工仍然保持了高昂的士气,采用了机器人护理系统。通过揭示社工的具体角色,本研究有助于加深对成功的机器人养老护理背后错综复杂的动态因素的理解。
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引用次数: 0
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Social Work in Health Care
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