Health & Social Care in the Community最新文献

This article explores the experiences of Black newly qualified social workers and student social workers in England. Drawing on related studies that have begun to outline the challenges faced by Global Ethnic Majority social workers in the UK, the article highlights that this is both an important and under-researched area. The article provides a much-needed contribution to understanding the unique experiences of Black social workers through a thematic analysis of interviews with Black social workers, providing an opportunity for social work colleagues, managers, educators, and academics to understand the challenges and obstacles that these social workers face. The research reveals a dire situation in which Black social workers are hindered by racial stereotyping, discrimination, and invisibility. Black social worker voices also highlight suggestions for best practice and guidance for the social work sector about how to improve. By centering these underrepresented voices, this article provides an opportunity to acknowledge and begin to rectify the barriers and challenges that Black social workers face.

This study examined the associations between community social capital and self-reported oral health among older adults in urban China, as well as the moderating effect of household income and the mediating role of depressive symptoms in these associations. Data were obtained from a community survey conducted in 2020 in Tianjin and Shijiazhuang City, China; the final analytical sample comprised 776 adults aged 60 years and above. To test the proposed moderation and mediation models, the data were analysed using binary logistic regression models and a path analysis, respectively. The findings showed that cognitive social capital and social participation (i.e., an indicator of structural social capital) were significantly associated with self-reported oral health. Additionally, the results revealed that while income significantly moderated the association between cognitive social capital and self-reported oral health, depressive symptoms significantly mediated it. The findings not only highlight the crucial role of community social capital in promoting oral health in later life among low-income older adults but also provide important evidence for a psychosocial pathway between social capital and oral health. Given the impacts of income and depressive symptoms on the relationship between community social capital and oral health among older adults, future social policies and interventions to support oral health should target financially vulnerable older adults with poor psychological well-being.

Background. Permanent supportive housing (PSH) is an evidence-based solution to chronic homelessness. There are two common PSH models: place-based (PB) programs where clients live in one building with services provided onsite and scattered-site (SS) programs, which use community apartments coupled with mobile case management and support. Understanding the relative strengths and weaknesses of PB and SS is important for PSH planning and service delivery. This paper explores homeless service provider perspectives on these two models after the onset of the COVID-19 pandemic. Methods. Service providers (N = 37) from across 5 PSH agencies in Los Angeles that provided either PB or SS services during the pandemic participated in focus groups. Discussions were recorded, transcribed, and analyzed using template analysis, grounded theory, and inductive techniques. Results. Providers identified four major differences between PB and SS services: (1) challenges in finding placements; (2) managing relationships with landlords/property managers; (3) frequency of contact; and (4) community integration. Advantages of PB included ease of finding units, ease of managing relationships with landlords/property managers, greater ability to serve clients efficiently, more frequent client contact, and more community among residents. SS was seen to provide tenants with more opportunities to grow, live in healthier environments, and develop independence. During the pandemic, finding units for SS clients became more difficult, while differences between PB and SS related to frequency of contact and community integration became more attenuated. Conclusions. PB can be advantageous for clients with higher levels of acuity, whereas SS could be more appropriate for clients who are more stable and independent. PB programs are seen to have practical and logistical advantages, but some providers prefer SS services. Clients and providers should be matched to PSH configurations that best match their needs and preferences, and providers should be aware that public health emergencies may impact PB and SS settings differently.

Brief health and wellbeing conversations within the Third and Social Economy (TSE) sector (groups or organisations operating independently to family and government with social justice as the primary aim) could help to reduce health inequalities through increased access to disadvantaged populations. This study aimed to explore the acceptability of health and wellbeing conversations such as within the TSE, including their existence without specific training. A qualitative design was adopted, utilising semistructured, one-to-one interviews. Service providers (n = 15) and users (n = 5) across a variety of TSE settings including charities and religious settings were interviewed, most of whom had not received no specific training in initiating and engaging in health and wellbeing conversations. Reflexive thematic analysis was applied using Nvivo. Five themes were identified; TSE as an ecosystem of empowerment, an existing community-initiated style of health and wellbeing conversations, readiness to engage in brief health and wellbeing conversations, capabilities of TSE as determined by external factors, and apprehension towards health and wellbeing conversations. Generally, the safe and empowering TSE environment naturally fostered health and wellbeing conversations, mostly initiated by service users. The TSE shows a readiness to conduct health and wellbeing conversations through existing infrastructure, partnerships, expertise, and an ambition for social justice. Barriers include fear of worsening the situation such as damaging strong and trusting relationships with service users, safeguarding concerns, and the instability and uncertainty of funding within the TSE. Relevant recommendations in light of these findings are made, including that the TSE is appropriate for the conduct of health and wellbeing conversations, and funding would provide cost efficiencies for its delivery at scale. Specific training within the TSE should focus on actively initiating health and wellbeing conversations and addressing fears of adverse consequences.

Social prescribing link workers are recently introduced roles in English primary care. One of their intended functions is to support patients with conditions influenced by the wider, social determinants of health. Their main purpose is to connect people to community resources to meet their nonmedical needs. However, our research reveals that link workers provide not only connections but also what we have described as “holding” for individuals with complex needs, who lack informal networks of support or who are waiting to access services. We explore the concept of holding, its meaning and significance in this context, and consider its consequences. As part of a realist evaluation, we observed seven link workers in GP practices in England during focussed ethnographies over a 3-week period. We took field notes and interviewed 61 patients and 93 healthcare and voluntary sector professionals. Nine to twelve months later, we carried out follow-up interviews with forty-one patients, seven link workers, and a link worker manager. We identified four functions of holding: supporting patients waiting for services, sustaining patients as they prepare for change, reducing the emotional burden of primary healthcare professionals, and bearing witness to patients’ distress. Holding appears to be a vital but often overlooked aspect of social prescribing. Patients benefit from having a reliable and consistent person to support their emotional needs. However, similar to the impact of holding on other primary care professionals, there are unintended consequences: some link workers exceed their capacity, become overburdened, experience burnout, and leave their job. Recognizing the importance of holding and understanding its role in link workers’ primary care responsibilities are critical. If holding work is accepted as a role for link workers, providing training and support to them should be prioritised to ensure successful implementation and positive outcomes for patients, link workers, and primary healthcare staff.

Caring for an autistic child is fraught with various difficulties and may present unmet needs that could affect the overall well-being of caregivers and children themselves. Consequently, gaining insight into the unmet needs of these caregivers is imperative for the development of targeted and effective interventions to enhance their quality of life and improve their ability to care for their children. Using a descriptive qualitative research design, this study engaged 10 primary caregivers of autistic children in Ghana to understand their unmet needs. Data were collected through in-depth interviews and thematically analyzed. The analysis revealed the urgent need for financial support for primary caregivers, the availability of more special schools, and the services of trained professionals in the field of autism. Caregivers also called for the intensification of public education to help reorient the perspectives of the general population on the autism condition. Based on the findings, some recommendations for policy and practice were made. The implications of the findings for social work are also discussed.

Objectives. How geriatric care models impact the health-related behaviors of the elderly and the function of social support within this context. Methods. We conducted binary logistic regression and PSM-DID analyses using data from the China Tracking Survey of Factors Influencing Elderly Health (CLHLS) and the China Health and Aging Tracking Survey (CHARLS). Results. Compared to living alone, other aging models negatively affected health behaviors. In the living with family model, parental intergenerational support attenuated these effects, while children’s financial support reduced negative impacts on health-protective behaviors. In the institutional model, negative effects on health-hazardous behaviors were exacerbated by emotional and social support. Loneliness and a lack of self-worth were crucial pathways. Discussion. Governments should offer public services to alleviate the intergenerational support burden on older individuals and strengthen social support for them.

Objectives. The goal of this review is to identify the experiences of the adoption assessment process for LGBTQ + adoptive parents. The intention is to highlight the scope of current literature, identify any research gaps, and from these, make recommendations for policy, practice, and research. Design. A scoping review. Methods. Social Policy and Practice, Medline, PsychINFO, ASSIA, British Education Index, International Bibliography of the Social Sciences, Scopus, Social Services Abstracts, and Google Scholar databases were searched. Articles were screened at the title and abstract level and at full text by two reviewers. The PAGER framework for scoping reviews was utilised. Results. A total of 413 articles were screened at the title and abstract level, of which 74 were also assessed at full text for eligibility. The 16 studies identified for inclusion originated from 6 different countries, with the most prevalent being the United States (10). Conclusions. Adoption processes are heterocentric which creates difficulty for LGBTQ + people in navigating them effectively. Examples of inclusive practice are evident in the literature. Process change and inclusion need to occur at organizational and policy levels rather than being the sole responsibility of social care practitioners. Future research is needed with underrepresented groups within the LGBTQ + community.

Fuel poverty was a significant problem during the cost-of-living crisis that started in 2021 as energy prices increased. Local authorities launched warm bank schemes around the United Kingdom to address this problem by providing warm spaces for residents to visit who could not heat their homes. This paper reports on an evaluation of the warm bank scheme launched by South Tyneside Council in winter 2022, locally known as Welcoming Places. Over 70 locations were opened around the borough. The evaluation consisted of two stages. In stage 1, we conducted semistructured interviews (n = 16) with residents who attended Welcoming Places and two focus groups with people running them (n = 9). In stage 2, we discussed the initial findings from stage 1 in a focus group with residents (n = 8). Three major themes are presented: “help and support with the cost-of-living crisis,” “it’s worth its weight in gold,” and “capability and strength of Welcoming Places.” This is one of the first evaluations of a warm bank scheme in England. We illustrate how the Welcoming Places in South Tyneside were used and experienced by residents. The scheme was valued by residents, provided significant support during the cost-of-living crisis, and had a positive impact on self-reported mental health among participants. Warm bank schemes offer a practical, rapid public health response to the cost-of-living crisis for local authorities as well as improving residents’ mental health and well-being; however, holistic approaches must be taken to address the underlying causes of fuel poverty.

Evidence indicates growing demand on community health and social care services by people with severe obesity (BMI ≥40 kg/m²), often due to functional limitations. The experiences of this population are largely unexplored. As part of a larger mixed-methods study, this qualitative study explored the lived experience of people with severe obesity using community health and social care services. Participants were recruited via community professionals and visited at home. They consented to individual, audio-recorded, semistructured interviews, which were transcribed and analysed using thematic analysis. Nine women and three men (n = 12) participated, aged 40–76 (mean 60) years, BMI ranged from 45 to 74 (mean 59) kg/m², and eight were housebound. Three overarching themes were identified. Firstly, the hidden struggles of living with a larger body affected all participants, including functional limitations affecting mobility and personal care. These contributed to a sense of being stuck physically, socially, and biographically. Secondly, most participants reported implicit weight bias by a system structurally unprepared to care for people with larger bodies. The majority of participants showed strong internalised weight bias, linked to shame and self-blame for their poor function and larger bodies. Thirdly, a day-to-day coping theme highlighted strategies regularly used by participants: resigned acceptance, avoidance and denial, exercising choice, and support from informal carers. These findings demonstrate that participants experienced unmet physical and psychological care needs associated with living with a larger body, leading to poor quality of care and life. Given rising prevalence, changes to care services are needed. Specific recommendations include staff training about the needs of people with severe obesity, ensuring that the physical infrastructure of care services can safely accommodate people with severe obesity, and improving access to effective, person-centred weight management treatments.