Showing papers in "Social Work in Health Care in 2005"

Is the glass half empty or full? Reflections on strain and gain in cargivers of individuals with Alzheimer's disease.

Abstract: While caregivers of individuals with Alzheimer's disease or a related dementia experience a range of caregiving burdens or strains, it has been found that they also experience positive outcomes or gains. This study examined both the caregiver strains and gains in a diverse urban sample of 85 caregivers (spouses and adult children). Eighty-one percent of the caregivers reported both strains and gains, while 19% of the caregivers reported only experiencing strains. The caregiver strains originated from worries and uncertainties, balancing multiple demands, and feeling overwhelmed with care, while spiritual growth, personal growth, and feelings of mastery produced feelings of gain. Implications for clinical social work practice will be presented.

Facial disfigurement and sense of self in head and neck cancer.

Abstract: People who suffer facial disfigurement as a result of head and neck cancer experience profound psychological trauma. This article will describe the role that the face plays in an individual's sense of self and body integrity; the psychological impact on self-esteem; physiological dysfunction with or without disfigurement that pose obstacles to meaningful therapeutic communication; implications for individual and group psychotherapy; and tasks of psychological recovery related to a transformed sense of face, body, and self.

Bibliometrics: a potential decision making aid in hiring, reappointment, tenure and promotion decisions.

Abstract: The assessment of scholarship assumes a central role in the evaluation of individual faculty, educational programs and academic fields. Because the production and assessment of scholarship is so central to the faculty role, it is incumbent upon decision makers to strive to make assessments of scholarship fair and equitable. This paper will focus on an approach to the assessment of the quantity and impact of the most important subset of an individual's scholarship-peer-reviewed journal articles. The primary goal of this paper is to stimulate discussion regarding scholarship assessment in hiring, reappointment, tenure and promotion decisions.

The measurement of body-mind-spirit well-being toward multidimensionality and transcultural applicability.

Abstract: The Body-Mind-Spirit model of health promotion (Chan, Ho, & Chow, 2002) guided the construction of a multidimensional inventory for assessing holistic health. Named Body-Mind-Spirit Well-Being Inventory (BMSWBI), it comprises four scales: Physical Distress, Daily Functioning, Affect, and Spirituality (differentiated from religiosity and conceived as ecumenical). Respondents (674 Chinese adults from Hong Kong) completed the BMSWBI via the Internet. Results indicate that all four scales have high reliability, with alpha coefficients ranging from .87 to .92, and concurrent validity. Factor analysis indicates that (a) positive and negative affect form two distinct factors, and (b) spirituality comprises three distinct aspects: tranquility, resistance to disorientation, and resilience. Spirituality is positively associated with mental well-being, positive affect, satisfaction with life, and hope; but negatively associated with negative affect and perceived stress. These results suggest that the invent...

Coping and Resilience of Children of a Mentally Ill Parent

Abstract: This paper examines the needs and stress reactions of children of mentally ill parents, as well as coping and resilience. The study is based on the interviews of six 9-11 years old children and narratives of seventeen female grown up children of mentally ill parents. The younger and older children of the mentally ill parents had not been informed about their parent's illness. The illness of the parent aroused a variety of emotions in them. The children used both practical problem solving and emotional coping mechanisms. Informal social support was available to them but seldom from the public services. It is recommended that professionals in mental health and child welfare services clarify their roles when working with mentally ill parents. The best interest of the child and the parenting they need should be carefully assessed. Open care measures should be offered to families early enough to prevent serious child welfare and mental problems.

Can Skill-Development Training Alleviate Burnout in Hospital Social Workers?

Abstract: Staff development programs, which focus on imparting and improving intervention skills, are acknowledged as an efficient way to reduce burnout, but few studies have examined this effect. The aim of the present study was to detect any difference in the level of social worker's burnout before and after attending two different skill-development groups, namely group-intervention skills for more experienced social workers and general hospital social-work skills for less experienced. Twenty-five hospital social workers participated in the study. The three dimensions of burnout, namely emotional exhaustion, depersonalization, and personal accomplishment, changed between the pre-training and post-training measures: personal accomplishment rose by 12.39% and depersonalization fell by 29.75%. The difference was significant for the two dimensions in both groups. Emotional exhaustion significantly declined in the hospital social-work skills group only, and revealed a group-time effect. The level of peer support rose in the hospital-skills group and was positively related to a lowering of emotional exhaustion. This was an exploratory study, with a rather small sample, and the results are preliminary, but they show a promising possibility of burnout reduction among professional workers. Further research on the effect of skill development training on reducing burnout is needed.

Social workers' educational needs in end-of-life care.

Abstract: A survey of 391 health care social workers assessed educational content and skills needed for competence in practice with those facing the end of life. Content perceived as most needed included psychological and social needs of patients and families; psychosocial interventions to ameliorate distress; and the influence of dying on family dynamics. Assessing complex needs of patients/families; communication of psychosocial needs of patient/family to team members; facilitation of effective family and team communication; and provision of crisis intervention were the skills perceived to be required for competence in end-of-life care practice. Results of these data can be used to develop model end-of-life care curricula for continuing education programs and to identify content for possible inclusion in social work programs.

Tracing thought through time and space: a selective review of bibliometrics in social work

Abstract: Bibliometrics is a field of research that examines bodies of knowledge within and across disciplines. Citation analysis, a component of bibliometrics, focuses on the quantitative assessment of citation patterns within a body of literature. Citation analysis has been used in social work to examine the quantity and the impact of the work of individuals and academic institutions. This paper presents a selective review of these uses of bibliometrics within social work.

Psychosocial problems and coping patterns of HIV seropositive wives of men with HIV/AIDS.

Abstract: The sociocultural milieu provides HIV positive women with fewer resources and more role responsibilities. The present research aimed at studying the psychosocial problems encountered in living, post HIV infection, and the coping patterns adopted by HIV seropositive wives of men with HIV/AIDS. In the background of an exploratory research design, thirty (n = 30) HIV positive women, attending Counseling Clinics in Bangalore (South India), selected through purposive sampling, were assessed using an interview schedule and a standardized coping scale. Majority of the respondents were the primary caregivers for their infected spouse and/or children. Content analysis of the problems revealed increased financial difficulties; problems in child care and support; compromised help-seeking due to stigma; problems in sexual interactions and communication in their marital relationship; role strain in caregiving; gender discriminatory and inadequate care; and increased concerns about parenting efficacy, post HIV infection. Escape avoidance was the most preferred coping strategy adopted by them. Situating the illness in a socio-familial context is indicated, and implications for social work and mental health practice follow from the findings.

The long-term psychosocial effects of cancer diagnosis and treatment on children and their families.

Abstract: Using both qualitative and quantitative methods, a study of 77 families was undertaken to examine the long-term psychosocial effects of cancer on children and their families. This paper focuses specifically on the findings in relation to the parents' subgroup of the overall study. Key findings were that the majority of parents and their children readjust to ordinary family life following completion of treatment. Gender differences in parents' coping mechanisms emerged. The period immediately following the cessation of treatment can create feelings of isolation and vulnerability, and many parents have ongoing worries about their child's continued well-being.

Using music as a therapy tool to motivate troubled adolescents.

Abstract: Children and adolescents with emotional disorders may often be characterized by having problems in peer and adult relations and in display of inappropriate behaviours. These include suicide attempts, anger, withdrawal from family, social isolation from peers, aggression, school failure, running away, and alcohol and/or drug abuse. A lack of self-concept and self-esteem is often central to these difficulties. Traditional treatment methods with young people usually includes cognitive- behavioural approaches with psychotherapy. Unfortunately these children often lack a solid communication base, creating a block to successful treatment. In my private clinical practice, I have endeavoured to break through these communication barriers by using music as a therapy tool. This paper describes and discusses my use of music as a therapy tool with troubled adolescents. Pre- and post-testing of the effectiveness of this intervention technique by using the Psychosocial Functioning Inventory for Primary School Children (PFI-PSC) has yielded positive initial results, lending support to its continued use. Music has often been successful in helping these adolescents engage in the therapeutic process with minimised resistance as they relate to the music and the therapist becomes a safe and trusted adult. Various techniques such as song discussion, listening, writing lyrics, composing music, and performing music.

Social work at the heart of the medical team.

Abstract: This paper proposes one model of hospital social work delivery services that places social work in a facilitative role within the medical team, and describes a pilot project designed to evaluate these services. Social work's role in this teaching hospital setting was tailored to provide patients and medical staff access to social work services upon admission, rather than at the time of discharge. This change places social work at the pivotal juncture to improve medical care and addresses the social, cultural and environmental concerns as they surface during patient stay. Unique to this demonstration model is the added advantage of placing the social worker at the hub of the physician-led medical team. Medical students, residents, and attending physicians all learn, observe, and experience the advantages social workers bring to the process. Educating medical students on teams with social workers bodes well for the profession. The authors summarize the program design, results and implications for social work practice in a teaching hospital setting.

Advance Directive Communication Practices: Social Workers' Contributions to the Interdisciplinary Health Care Team

Abstract: This article presents a comparative study about social work- ers' interdisciplinary advance directive communication practices with pa- tients at several hospitals located in upstate New York. The sample consisted of physicians (n = 32), nurses (n = 74), and social workers (n = 29). The research surveyed advance directive communication practices by discipline utilizing a self-administered questionnaire. Advance directive communication was operationalized as a cumulative process incorporating the following phases that were measured as scales: initiation of the topic, disclosure of information, identification of a surrogate decision-maker, dis- cussion of treatment options, elicitation of patient values, interaction with family members, and collaboration with other health care professionals. Re- sults suggest that social workers offer distinct skills in their advance direc- tive communication practices and discuss advance directives more frequently than either physicians or nurses. (Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website: © 2005 by The Haworth Press, Inc. All rights reserved.)

Social support factors and health among a senior center population in southern Ontario, Canada.

Abstract: Past research on senior centers has mainly focused on utilization, frequency, duration of attendance, participation or various activities and services. This study strives to go beyond previous research by examining social support factors and their relationship to mental and physical health across a senior center population in southern Ontario, Canada. Data were collected at two large senior centers in the Kitchener, Waterloo area. We used a self-administered survey among a sample of older participants (n=186). One-way ANOVA with post-hoc Duncan's multiple range tests, t-tests, and linear regression analyses were used to examine the influence of social support (friendship, caregiving and advice) on mental and physical health. The results indicated that caregiving is significantly related to physical health, how respondents feel in general, and happiness with personal life. Advice from others is significantly related to perceptions of having a life full of interesting things. Additionally, respondents who are volunteers perceive better health and social support than non-volunteers, those who eat at the center perceive better health and caregiving support, and those that started a new activity perceived better health and social support from friendships. Implications for social work practice, policy and future research are discussed.

Driving habits and patterns in older men with glaucoma

Abstract: Glaucoma, an eye disorder that gradually decreases peripheral vision, affects millions of older adults. Consequences of glaucoma can mean changes in the ability to perform familiar tasks, including driving an automobile. We surveyed older drivers with glaucoma and a control comparison group in order to learn more about their driving habits and expectations about driving cessation. Findings indicate that compared to the control group, drivers with glaucoma are significantly more likely to change their driving habits with regard to driving at night (p = 0.003), on freeways (p = 0.05), and in unfamiliar areas (p = 0.01). Drivers with glaucoma were also significantly more likely to report family concern about their driving (p = 0.01). However, the drivers with glaucoma did not anticipate that their disease would force them to discontinue driving. Social workers play a pivotal role in coordinating the complex care needs of visually impaired elders. When driving skills are affected, social workers must...

Coping with Type 2 Diabetes: Do Race and Gender Matter?

Abstract: OBJECTIVE-The aim of this study was to identify the coping methods of adults with type 2 diabetes, explore whether patient race (African-American vs. white, non-Latino) and gender (female vs. male) influenced coping style, and then analyze the relationship between coping and self-assessed diabetic control (self-management success). RESEARCH DESIGN AND METHODS-From an exploratory research design using a mixed-methodological approach, in-depth interviews were conducted with 34 interviewees-9 black females, 5 black males, 15 white females, and 5 white males-living in a large mid-South city. Interviews were audio-taped, transcribed, then unitized and codified for analysis. RESULTS-Interviewees reported 136 strategies, collapsed into 40 distinct coping methods. Race and gender differences first were observed in the frequency distributions of methods. Whites reported significantly more problem-focused methods than African-Americans. Males reported, overall, fewer methods, less emotion-focused, yet more...

A career in hospital social work: do you have what it takes?

Abstract: Hospitals present a variety of complex challenges for social work practitioners. Clinical social workers deal with emotionally intense and potentially draining cases in a setting where they are often faced with threats to their identity or existence. They must balance their role as patient advocates with institutional needs and be able to adjust to ever-changing models of health care delivery. Why do some social workers thrive in this environment while others struggle to survive? This article draws upon the author's twenty-year career in hospital social work to provide a "snapshot" of the clinical social work role in teaching hospitals. Included in the discussion are observations about the unique aspects of clinical practice in the hospital and strategies for surviving power struggles, turf battles and hospital "politics."

Adjustment to breast cancer: the contribution of resources and causal attributions regarding the illness.

Abstract: The study examined personal resources (sense of coherence and social support) and attributions concerning the causes of illness, and their relationship to adjustment to breast cancer. The research sample included 60 Israeli women with breast cancer, who responded to questionnaires at two stages of their illness: the stage of initial discovery (after first learning of the illness) and approximately six months later (the stage of mitigation and accommodation). The overall level of adjustment to the illness was moderate. While the patients adjusted relatively well in the family and domestic environments, their adjustment in the dimensions of health care, psychological distress, and sexual relations was relatively low. The most frequent causal attributions were psychological factors and family history of illness. The patients' subjective state of health, sense of coherence, and levels of social support were related to most of the adjustment dimensions examined, although both internal and external cau...

Nursing home social worker skills and end-of-life planning.

Abstract: Little empirical information exists on nursing home social worker's involvement in advance care planning and end-of-life decision- making with nursing home residents and their family members. The purpose of this exploratory study was twofold: (1) to identify the frequency of skills associated with advance care planning that social workers use, and (2) to explore the factor structure of the scale used in the study. Results from 138 nursing home social worker respondents from New York State showed high frequency of advance directive discussions, care planning, and conflict resolution with families. The instrument factors clustered around administrative duties, and grief issues. There was substantial interest in continuing education in grief counseling with families.

Social work with a pet loss support group in a university veterinary hospital.

Abstract: This article describes the development of a bereavement support group for pet owners in a university veterinary hospital. The group is predicated on the understanding that a human-animal relationship can be strong and the loss of that bond, through the animal's death, can produce a grief reaction, though this problem is often overlooked. The description of the support group is presented in detail so that it may be replicated. Included are: the history of the group, the procedure for making clients aware of the group, the program, the demographics, and problems brought to the group. The discussion and conclusion support the development of interdisciplinary collaborations among veterinarians, owners and social workers in other veterinary hospitals.

Partnership in mental health and child welfare: Social work responses to children living with parental mental illness

Abstract: Mental illness is an issue for a number of families reported to child protection agencies. Parents with mental health problems are more vulnerable, as are their children, to having parenting and child welfare concerns. A recent study undertaken in the Melbourne Children's Court (Victoria, Australia) found that the children of parents with mental health problems comprised just under thirty percent of all new child protection applications brought to the Court and referred to alternative dispute resolution, during the first half of 1998. This paper reports on the study findings, which are drawn from a descriptive survey of 228 Pre-Hearing Conferences. A data collection schedule was completed for each case, gathering information about the child welfare concerns, the parents' problems, including mental health problems, and the contribution by mental health professionals to resolving child welfare concerns. The study found that the lack of involvement by mental health social workers in the child protection system meant the Children's Court was given little appreciation of either a child's emotional or a parent's mental health functioning. The lack of effective cooperation between the adult mental health and child protection services also meant decisions made about these children were made without full information about the needs and the likely outcomes for these children and their parents. This lack of interagency cooperation between mental health social work and child welfare also emerged in the findings of the Icarus project, a cross-national project, led by Brunel University, in England. This project compared the views and responses of mental health and child welfare social workers to the dependent children of mentally ill parents, when there were child protection concerns. It is proposed that adult mental health social workers involve themselves in the assessment of, and interventions in, child welfare cases when appropriate, and share essential information about their adult, parent clients. Children at risk of abuse and neglect are the responsibility of all members of the community, and relevant professional groups must accept this responsibility.

How do tangible supports impact the breast cancer experience

Abstract: A woman's ability to navigate her new role as a breast cancer patient can be impacted by the support she has available to her during this time. One form of social support, tangible support, refers to providing support in a physical way that assists an individual in meeting their role responsibilities. The Roy Adaptation Model was used as a framework for conceptualizing the various roles in a woman's life that can be impacted by breast cancer and how the type and extent of tangible support impacts these roles. Through a qualitative open-ended interview 33 women with breast cancer described their experiences with their illness as it pertains to issues of role function and tangible supports.

Parents as advocates: stories of surplus suffering when a child is diagnosed and treated for cancer.

Abstract: Twenty-nine parents of children who had been diagnosed with cancer were interviewed through long and relatively unstructured interviews conducted via telephone by a mother whose own daughter once had cancer. Parents were asked to tell the story of their experiences during the time that they were 'going through' cancer. Parents usually began their narrative in the months, weeks, or days prior to the diagnosis. They spoke of various parts of the story. In this paper, the focus is on one topic that parents talked about a lot. We call this 'problems with the system' or 'surplus suffering.' Here parents reported on their perceptions of mistakes, and delays in diagnosis, errors, carelessness, and unkindness during treatment. They talked of how they felt they had to be on constant guard, and at times, to intervene in their child's care. This paper provides a picture of parental expectations and their violation during the treatment of their children for cancer. It begins to demonstrate how parents see themselves as advocates for their children in a context of fragile power relations.

Social vaccine for HIV prevention: a study on truck drivers in South India.

Abstract: Nearly everywhere that AIDS has been found, HIV infection is fast spreading. No one is known to have recovered from HIV infection. There is no vaccine to cure AIDS (Population Reports, 1989 and The Hindu, dated 9.3.2000). Until a cure or vaccine for HIV infection is found, the only way to prevent the spread of the disease is by changing people's behaviour through AIDS education programmes (Population Reports, 1986). Many national governments are using broadcast, print media, personal contact, counselling methods, etc., to educate people on AIDS and safer sex. Thus, the best vaccine is the 'Social Vaccine.' Social vaccine involves spreading education on how to protect oneself, hundred percent condom use, and changing sexual behaviour. In fact, the social vaccine was so successful in Thailand that the infection rate has come down by 50 per cent (The Hindu, dated 9.3.2000). Truck drivers, prostitutes, and young adults are considered high risk groups for HIV/AIDS in India. An action research study was conducted in Chittoor District of Andhra Pradesh (India) among truck drivers. As part of this study, different strategies, namely mass media, personal contact, group discussion, folk media, and counselling, were adopted to provide AIDS education, to encourage increase in condom use for safer sex, and bring changes in their sexual behaviour. The strategies adopted in this study greatly enhanced the knowledge of the truck drivers on AIDS, changed their attitudes on sex, increased the use of condoms, and modified their sexual behaviour. Thus, the social vaccine would help spread education on AIDS, bring changes in the sexual behaviour of the people, increase condom use, and thus help to prevent the AIDS scourge throughout the world. The social vaccine suggested in this study can also be extended to all the high risk group population for successful prevention of this dreadful disease in the world.

APS Workers Job Requirements Associated with Elder Abuse Rates

Abstract: The purpose of this paper is to evaluate the relationship of required educational background of APS workers to the 1999 rates of domestic elder abuse. Data were obtained from APS related statutes and regulations and questions to the National Center for Elder Abuse list serve. Descriptive statistics and independent sample t-tests were used for analyses. Those states whose legislations required a social work degree for APS caseworkers did have higher elder abuse investigation rates. A lower substantiation ratio was found for those states requiring a social work degree or license. These findings suggest that social work education may lead to an emphasis on investigation and interventions and de-emphasis on the criminal aspects of elder abuse evaluation substantiations.

Cultural and ethical issues in working with culturally diverse patients and their families:the use of the culturagram to promote cultural competent practice in health care settings.

Abstract: In all aspects of health and mental health care-the emergency room, the outpatient clinic, inpatient facilities, rehab centers, nursing homes, and hospices-social workers interact with patients from many different cultures. This paper will introduce an assessment tool for health care professionals to advance understanding of culturally diverse patients and their families.

Whose power/authority/knowledge? Conundrums in the experiences of parents whose children have cancer.

Abstract: This paper is based on data collected from two different studies of parents (76 mothers and 14 fathers) whose children had been diagnosed with cancer. Although the goal of the first study, to describe parental experiences when their children have cancer, was different than the goal of the second study, to describe the home health care work done by parents whose children had cancer, the themes outlined here were reiterated from study to study. In both sets of data conflicts in the dynamics of power, authority and knowledge were pivotal to the dilemmas experienced by parents in their interactions with health care staff both during the time of diagnosis and later during the treatments when their children had cancer. The paper points to the significance of fundamental social processes such as power, authority and knowledge in understanding and ameliorating parental experiences when a child has cancer.

The Experience of Urban Aboriginals with Health Care Services in Canada

Abstract: This exploratory study investigates the experience of Canadian Urban Aboriginal persons as consumers of health care services. Results highlight significant gaps in the training, skills, and knowledge of health care providers to optimally serve their Aboriginal patients. Also, several programs which are potentially most problematic for Aboriginal patients are identified. The discussion outlines important roles for hospital social workers in improving the care provided to urban Aboriginal patients.

Time to father.

Abstract: This paper reports the qualitative findings from 40 couples involved in a study exploring men's post-natal mental health. Interviews were conducted with individuals soon after the birth of their first child. Findings suggest that new fathers want to be more involved in the direct care and nurturing of their children than their fathers were with them. Discourses which construct fathers and inform social structures have not kept pace with men's changed attitudes and role expectations limiting the options available to men as fathers. In particular men's employment circumstances figure in their experience of adjusting to life as a father. Those fathers having least flexibility and autonomy in their work report experiencing, since the birth of their child, more unhappi-ness, anxiety, and generally higher levels of stress. These findings suggest increasing workplace flexibility and provisions such as parental leave are important for men's post-natal mental health.

Understanding the interconnections between ethnicity, gender, social class and health:experiences of minority ethnic women in britain.

Abstract: This paper presents the findings of a qualitative study about the impact of ethnicity, gender, and socio-economic status upon health, and use and access to appropriate service provision. A total of 54 interviews were carried out with women who identified themselves as Muslim and Bangladeshi. Health and social care professionals were also interviewed. However, the focus of this paper is upon the ways in which women conceptualised their health and social care needs and concerns. Our findings indicate that individual characteristics serve to mediate the influence of gender and ethnicity on health, but for the women in our study, socio-economic status represents the most potent factor in adversely affecting their health status and access to health care.