Showing papers in "Social Work in Health Care in 2009"
TL;DR: The results showed that upward communication moderated the relationship between stress and burnout, and a conceptual model of supervisory communication had not only an indirect effect on burnout and turnover intention through its effect on stress, but also a direct effect on turnover intention.
Abstract: The current study tests the effects of different types of supervisory communication on burnout and turnover intention among health social workers. The study proposed a conceptual model of supervisory communication and tested it empirically using structural equation modeling (SEM) techniques with a random sample of 211 California state-registered social workers working in health or mental health care settings. The results of the present study provide empirical evidence of the unique roles that different types of supervisory communication play as antecedents of burnout and turnover intention. Specifically, supportive relationship communication had an indirect effect on burnout and turnover intention through its effect on perceived stress, whereas job-relevant communication had not only an indirect effect on burnout and turnover intention through its effect on stress, but also a direct effect on turnover intention. In addition, the results showed that upward communication moderated the relationship between stress and burnout. Implications for social work administration and possible elaboration of the theoretical framework are discussed.
124 citations
TL;DR: The findings highlight the importance of constructing innovative strategies to mitigate chronic disease risk factors in this population that involve community-based case management service providers who can help adults with ID and their families adopt needed lifestyle and behavior changes.
Abstract: Advances in health care for people with intellectual disabilities (ID) that have resulted in increased longevity also force health care providers, researchers, and policymakers to question the adequacy of chronic disease management for the growing number of middle aged and elderly persons in this population. We report on sociodemographic and clinical factors associated with obesity, hypertension, hypercholesterolemia, and diabetes mellitus in an ethnically/racially diverse sample of people with ID in New York City. Administrative and chart review data were collected from a community-based specialty medical practice for people with intellectual disabilities. Adult subjects were included if they had an intellectual disability, lived in the community either independently or with relatives, received all of their planned, outpatient health care services though this practice, and had a primary care visit within the study period. One hundred twenty-six (43.0%) persons were obese, 58 (19.9%) had hypertension, 77 (26.5%) had hypercholesterolemia, and 13 (4.5%) had diabetes mellitus. Age, gender, and BMI (for the latter three conditions) were the most consistent risk factors. Intellectual functioning and behavioral problems were not associated with greater odds of these conditions. This study provides crucial information for improving community-based primary care for people with intellectual disabilities. Specifically, these findings highlight the importance of constructing innovative strategies to mitigate chronic disease risk factors in this population that involve community-based case management service providers who can help adults with ID and their families adopt needed lifestyle and behavior changes.
66 citations
TL;DR: Findings from three focus groups with primary care physicians and nurses are presented to examine the perspectives of these key providers about the benefits and challenges of integrating social workers into the primary care team.
Abstract: The primary aim of this article is to identify, from the perspective of primary care physicians and nurses, the challenges encountered in provision of health care to older adults and to identify potential roles, challenges, and benefits of integrating social workers into primary care teams. As more older adults live longer with multiple chronic conditions, primary care has been confronted with complex psychosocial problems that interact with medical problems pointing to a potential role for a social worker. From a policy perspective, the lack of strong evidence documenting the benefits that will accrue to patients and providers is a key barrier preventing the wider use of social workers in primary care. This article presents findings from three focus groups with primary care physicians and nurses to examine the perspectives of these key providers about the benefits and challenges of integrating social workers into the primary care team.
61 citations
TL;DR: The author extends McNeill's concept of “evidence-informed practice” to suggest a more inclusive and harmonious conception of practice–research integration, and considers what such a model might look like.
Abstract: This article identifies dualisms in the continuing and sometimes acrimonious discourse concerning the relationship between social work practice and research. In so doing, it describes the epistemological assumptions of and differences between evidence-based practice, research-based practice, practice-based research, and reflective practice. In the spirit of the Hong Kong conference, the author extends McNeill's concept of "evidence-informed practice" to suggest a more inclusive and harmonious conception of practice-research integration. The article concludes by considering what such a model might look like.
58 citations
TL;DR: The effect of attitude toward aging on mental health was stronger than most other predictive factors, and social workers should focus on creating social/community environments that build a positive attitude toward Aging.
Abstract: This study examined the predictive effects of attitude toward aging on mental health of aging Chinese. Data were obtained from community surveys utilizing mixed sampling methods of 4,240 elderly Chinese 55 years or older in China, Hong Kong, Taiwan, Canada, and the United States. Hierarchical multiple regression analysis was used, with sociodemographic variables entered first, followed by the health variables, and then attitude toward aging. The effect of attitude toward aging on mental health was stronger than most other predictive factors. Social workers should focus on creating social/community environments that build a positive attitude toward aging.
57 citations
TL;DR: Older age, lower self-perceived health, worse instrumental activities of daily living, psychiatric problems, and living alone were found significantly associated with increased risk of LSNH admission, while being female, African American, or Hispanic; owning a home; and having lower level of cognitive impairment reduced the admission risk.
Abstract: Two statistical methods were compared to identify key factors associated with long-stay nursing home (LSNH) admission among the U.S. elderly population. Social Work's interest in services to the elderly makes this research critical to the profession. Effectively transitioning the "baby boomer" population into appropriate long-term care will be a great societal challenge. It remains a challenge paramount to the practice of social work. Secondary data analyses using four waves (1995, 1998, 2000, and 2002) of the Health Retirement Study (HRS) coupled with the Assets and Health Dynamics among the Oldest Old (AHEAD) surveys were conducted. Multivariable logistic regression and Cox proportional hazards model were performed and compared. Older age, lower self-perceived health, worse instrumental activities of daily living (IADL), psychiatric problems, and living alone were found significantly associated with increased risk of LSNH admission. In contrast, being female, African American, or Hispanic; owning a home; and having lower level of cognitive impairment reduced the admission risk. Home ownership showed a significant effect in logistic regression, but a marginal effect in the Cox model. The Cox model generally provided more precise parameter estimates than logistic regression. Logistic regression, used frequently in analyses, can provide a good approximation to the Cox model in identifying factors of LSNH admission. However, the Cox model gives more information on how soon the LSNH admission may happen. Our analyses, based on two models, dually identified the factors associated with LSNH admission; therefore, results discussed confidently provide implications for both public and private long-term care policies, as well as improving the assessment capabilities of social work practitioners for development of screening programs among at-risk elderly. Given the predicted surge in this population, significant factors found from this study can be utilized in a strengths-based empowerment approach by social workers to aid in avoiding LSNH utilization.
55 citations
TL;DR: Results indicate fathers to be profoundly affected by their child's condition of cancer, and post-diagnosis lived experience is described to hold new meaning as fathers reconcile the presence of childhood cancer within the life of their child and family.
Abstract: This study examines the experiences of fathers of children diagnosed with cancer. In this grounded theory study, participating fathers were qualitatively interviewed using a theoretical sampling approach. Results indicate fathers to be profoundly affected by their child's condition of cancer. Fathers' experiences include isolation and heightened sadness and uncertainty. Paternal roles comprise providing family support, sufficient resources, and seeking to maintain family stabilization. Post-diagnosis lived experience is described to hold new meaning as fathers reconcile the presence of childhood cancer within the life of their child and family. Strategies of resistance are demonstrated as fathers combat the devastating impacts of cancer through a commitment to family integration, healthy personal lifestyle and attitudes, support seeking, spirituality, and reframing of priorities. An emerging model is presented, as are implications for practice and recommendations.
53 citations
TL;DR: The needs of medically underserved cancer patients were discussed and four key themes in the development of PN programs were revealed, including the need to address access to quality care issues, emotional and practical concerns of the cancer survivor, and the PN needs to address family concerns.
Abstract: Patient navigation (PN) is a new initiative in health care aimed at reducing disparities by assisting patients in overcoming barriers within the health care system. As PN programs grow around the country, it is important to consult the key stakeholders in the development of these programs. The purpose of this qualitative study was to discuss the needs of medically underserved cancer patients and allow them the opportunity to provide input on models of care to meet their needs. Four focus groups were conducted in three major cities across Tennessee. Research participants (n = 36) were recruited by the staff in area cancer support programs and treatment programs across the state and through recruitment flyers at various treatment centers and community organizations. Findings revealed four key themes in the development of PN programs: (1) the PN needs to address access to quality care issues; (2) the PN needs to address the emotional and practical concerns of the cancer survivor, (3) the PN needs to address family concerns; (4) the PN needs to be involved across the continuum of care from time of diagnosis into long-term survivorship. Oncology social workers have a unique opportunity to meet the needs of medically underserved cancer patients through the PN movement. Our profession is a key stakeholder in this movement. We need to advocate for trained oncology social workers to actively pursue the role of patient navigators to ensure that the needs of medically underserved cancer survivors and their families are met.
52 citations
TL;DR: Results suggest that this practice of sending American-born children to China to be raised by extended family members, and bringing them back upon reaching school age was common, and was significantly associated with certain maternal and family sociodemographic characteristics.
Abstract: A survey was administered to 219 Chinese immigrant women receiving prenatal and postnatal care in a community health center in New York City to examine the practice of and factors associated with "reverse-migration"-sending American-born children to China to be raised by extended family members, and bringing them back upon reaching school age. Results suggest that this practice was common (57%), and was significantly associated with certain maternal and family sociodemographic characteristics. Reasons leading to and perceived impact of reverse-migration separation were also explored. The long-term consequences of reverse-migration separation on child development or family dynamics are unknown. Further research is indicated on larger samples of low-income Chinese immigrant families to explore the prevalence and consequences of this practice.
42 citations
TL;DR: The changeover process, support, and consequences experienced by adults who acquired traumatic brain injury seemed to be a prolonged process, probably never-ending, which gradually became integrated as a part of life.
Abstract: The purpose of this study is to illuminate the changeover process, support, and consequences experienced by adults who acquired traumatic brain injury (TBI). Fifteen persons were in-depth interviewed using a semi-structured interview guide. Data were analyzed by latent-content analysis and structured into six themes. Consequences were negative as well as positive. Significant others were important as a driving force for training and life-situation. The informants were initially satisfied with social supports but in the longer term became more critical regarding accessibility to such supports. The majority had difficulties in returning to working life after injury. The outcomes seemed to be a prolonged process, probably never-ending, which gradually became integrated as a part of life.
37 citations
TL;DR: A qualitative dataset that gives a glimpse of the experiences and coping strategies of (older) people living in residential care indicates that “higher” and “lower” needs are closely intertwined and mutually reinforcing and should therefore be accorded equal emphasis by professionals employed within residential care settings.
Abstract: Insights into daily living in residential care settings are rare. This article draws on a qualitative dataset (semi-structured interviews and recordings of residents' council meetings) that gives a glimpse of the experiences and coping strategies of (older) people living in residential care. The data highlight the range of unmet needs of the residents, similar to the categories of physiological, safety, love, esteem, and self-actualization needs in Maslow's hierarchy of needs theory. Our analysis indicates that "higher" and "lower" needs are closely intertwined and mutually reinforcing and should therefore be accorded equal emphasis by professionals (including social workers) employed within residential care settings.
TL;DR: The findings suggested two possible pathways toward enhancing the psychosocial experience of dying patients, that is, the “family support pathway” and the ”familial-altruistic pathway.
Abstract: A good death is universally desired. For Chinese patients, the family is believed to play a key role in making this possible. This study aims at exploring the relationship of family-related factors and psychosocial outcomes among Hong Kong Chinese cancer patients in palliative care. Clinical data mining was adopted as the research method. Nurses collected data from clinical interviews with incoming palliative care patients. A total of 935 patients from three years of deceased patient records was included. Stepwise regression analysis demonstrated that “caregivers' support and acceptance” predicted fewer psychosocial symptoms of patients, whereas “depressed family response to patient's illness” and “family anxiety” predicted a greater number of psychosocial symptoms of patients upon their admission to palliative care. The findings suggested two possible pathways toward enhancing the psychosocial experience of dying patients, that is, the “family support pathway” and the “familial-altruistic pathway.” Furth...
TL;DR: Provider estimates of patients' problems were consistently lower than patient estimates in all psychosocial problem areas except need for nursing home placement and problem drinking or drug use, and Implications for social work in primary care are discussed.
Abstract: Primary care physicians and clinics have become the frontline of health care for most Americans-they are the first point of contact and the source of both treatment and referrals. Psychosocial problems, such as difficulty with finances, family, housing, and work, are associated with a high demand for medical care in primary care practice, yet little is known about the prevalence of psychosocial problems in primary care settings. The purpose of this study is to assess the type and level of psychosocial problems in primary care patients by examining patient and provider perceptions at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS). A purposive sample of 684 veterans and a convenience sample of 59 providers anonymously completed the Social Needs Checklist. Patients reported an average of five psychosocial problems, with finances, personal stress, transportation, employment, and legal issues being the most prevalent. Thirty-two percent of patients indicated a desire to see a social worker. Provider and patient differences were compared. Provider estimates of patients' problems were consistently lower than patient estimates in all psychosocial problem areas except need for nursing home placement and problem drinking or drug use. Implications for social work in primary care are discussed.
TL;DR: Early Start Plus provides clinicians with an innovative assessment tool that creates open dialogue about drinking during pregnancy that favored ESP for preterm labor and ES for low birth weight.
Abstract: This clinical trial compared two brief alcohol use interventions in prenatal clinics: Early Start (ES), a substance-abuse screening and treatment program integrated with prenatal care focused on abstention (n=298), and Early Start Plus (ESP), adding a computerized drink-size assessment tool and intervention focused on drinking less (n=266). Controls were untreated alcohol users (n=344). Controls had higher adverse neonatal and maternal outcome rates. Findings favored ESP for preterm labor and ES for low birth weight. No differences between ES and ESP were statistically significant. ESP provides clinicians with an innovative assessment tool that creates open dialogue about drinking during pregnancy.
TL;DR: The results showed that depressive symptoms were predicted positively by caregiving burden, while care Giving burden was predicted negatively by financial adequacy and positively by the level of activities of daily living and instrumental activities ofdaily living caregiving assistance provided.
Abstract: This study aims to understand the effect of caregiving burden on depressive symptoms in Chinese-Canadian family caregivers, an area on which little research has been conducted. A random sample of 339 Chinese-Canadian caregivers for elderly family members completed a structured telephone survey. The results showed that depressive symptoms were predicted positively by caregiving burden, while caregiving burden was predicted negatively by financial adequacy and positively by the level of activities of daily living (ADL) and instrumental activities of daily living (IADL) caregiving assistance provided. Culturally appropriate strategies are needed to support Chinese family caregivers in order to properly manage caregiving responsibilities, financial needs, and psychological burden.
TL;DR: Interviews with patients and cancer care professionals highlighted the salience to patients' treatment choices of experiential knowledge, social roles and responsibilities, and the health policy context.
Abstract: Patient participation in treatment decision making is held as a virtue in clinical contexts, and has much to recommend it. Yet important questions have been raised about the assumptions underlying models of patient participation. Debates have arisen about the significance of medically defined risks and outcomes of treatment; the adequacy and relevance across social groups of the concept of autonomy; and the emphasis on the professional-patient dyad. This article contributes to the debate about treatment decision making with reference to a study focused on older women with cancer. Interviews with patients and cancer care professionals highlighted the salience to patients' treatment choices of experiential knowledge, social roles and responsibilities, and the health policy context. It appears that prevailing models of decision making may obscure patients' more typical decision processes as well as the social determinants of those choices.
TL;DR: A high level of compliance was found with the duty to inform and a low level of complied with theduty to maintain professional boundaries, while the dutyTo maintain confidentiality and procedures to be used in an emergency yielded mixed results, raising some concerns.
Abstract: The purpose of this research is to evaluate the compliance of e-therapy websites to the NASW Code of Ethics. The E-therapy Site Compliance Evaluation Form (ESCEF) was used to retrieve data from 66 e-therapy websites with social workers. This study utilized a mixed method using both qualitative and quantitative approaches. A high level of compliance was found with the duty to inform and a low level of compliance was found with the duty to maintain professional boundaries. The duty to maintain confidentiality and procedures to be used in an emergency yielded mixed results, raising some concerns. Although a large percentage (59%) presented the procedures to be used in an emergency, only a third (32%) required giving information on local backups. Implications are discussed for social work practice, policy guidelines, research, and education.
TL;DR: Results of the study have shown that the belief in fate and luck, as well as stoicism about cancer, is very common among cancer patients and their family members.
Abstract: This article reports on the findings of a recent study of cancer experiences of members in the Chinese community in Brisbane, the state capital of Queensland. Results of the study have shown that the belief in fate and luck, as well as stoicism about cancer, is very common among cancer patients and their family members. Their general strategy for coping with cancer is often passive. Families play the most important role in determining the strategy for helping the cancer patients in coping with the illness. Most prefer to keep the illness secret and private within the family. Implications of the findings from this study will be discussed for the development of culturally appropriate programs for cancer prevention and treatment for the Chinese community.
TL;DR: A significant relationship between psychosocial severity and LOS was again found, confirming the important role that social services can potentially play in controlling hospital costs.
Abstract: In earlier studies it was found that the severity of patients' psychosocial problems was a significant predictor of length of stay (LOS). This current study compared predictors of LOS for samples of patients referred to social services in three large urban hospitals in June-October 2002 (n = 176) and 2006 (n = 147), and examined changes in patient characteristics and the nature of social work practice. A significant relationship between psychosocial severity and LOS was again found, confirming the important role that social services can potentially play in controlling hospital costs. Some significant changes were also found in the pattern of social work practice; this was generally in the direction of more community consultation and collaboration, suggesting a greater emphasis on multidisciplinary teamwork.
TL;DR: Findings from this qualitative study suggest that Zen meditation has direct application to clinical social work in three areas: cultivating Awareness, enhancing Acceptance, and (3) nurturing nurturing.
Abstract: The use of Zen Buddhist meditation in clinical practice has received specific attention from mental health disciplines in the West. A study was undertaken to examine the influence of a personal practice of Zen on the professional work of clinical social workers. Ten experienced clinical social workers who were long-term Zen practitioners were interviewed. Findings from this qualitative study suggest that Zen meditation has direct application to clinical social work in three areas: (1) cultivating Awareness, (2) enhancing Acceptance, and (3) nurturing Responsibility. This article reports on the findings in the area of Awareness. Awareness increases a social worker's focus on the present moment with the client, providing for a suspension of preconceived ideas about the client. Building on the view that social work is both art and science, the author proposes the use of Zen in the training of clinical social workers.
TL;DR: It is concluded that the DG is a lifeline for most HIV/AIDS-affected families and should not use CD4 cell counts as criterion for DG eligibility, and the conditions and characteristics of the DG should be fully explained to recipients.
Abstract: A cross-sectional explorative descriptive qualitative/quantitative study was conducted in the Eastern Cape of South Africa. The qualitative component involved 38 HIV/AIDS stakeholders who were interviewed telephonically using a semi-structured interview schedule. The quantitative component comprised 607 People Living With HIV/AIDS (PLWHA) who were interviewed using a structured questionnaire. The majority of PLWHA were female, never married, unemployed, aged between 26 to 45 years, Black African, and had more than grade 7 education. All stakeholders supported the disability grant (DG) because it improved the lifestyle of PLWHA. The CD4 count was cited as the main criterion for putting PLWHA on the DG. The conditions and characteristics of the DG were not clearly explained to PLWHA. The DG application process was viewed to be too long. Access to service points was perceived as a challenge for some PLWHA. The DG was used to meet basic household and health care needs. Not being on a DG was associated with lower CD4 counts, often without enough food, and less often without needed medicines in the past 12 months. Having the DG stopped was associated with often not having enough medicines that were needed in the past 12 months. We conclude that the DG is a lifeline for most HIV/AIDS-affected families. We recommend that DG should not use CD4 cell counts as criterion for DG eligibility; the conditions and characteristics of the DG should be fully explained to recipients; the DG application process should be completed within one day; PLWHA who no longer qualify for the DG yet do not have adequate financial means to meet basic necessities should be put on a nutritional support program; and access to the location of the grants by the poor and vulnerable should be improved.
TL;DR: The study found that rapport building, empathy, non-judgmentalism, practical assistance, and advocacy are important features of the social work role in the intense and time limited context of single session hospital social work.
Abstract: Decreasing lengths of stay in acute hospitals result in social workers often being unable to engage in planned interventions with clients over a number of sessions. Single session work is a reality for much social work practice. This article reports on a qualitative study of clients' experiences of a single contact with a social worker in a hospital setting. Building on prior research on hospital social workers' experiences of single session work, the study found that rapport building, empathy, non-judgmentalism, practical assistance, and advocacy are important features of the social work role in the intense and time limited context of single session hospital social work.
TL;DR: Investigation of the psychosocial mechanisms involved in the preoperative use of private prayer for coping and the effects of such act on short-term quality of life in 294 patients following open-heart surgery showed the indirect influence of using prayer for cope on SPQOL through the mediation of cognitive coping and perceived social support.
Abstract: Despite the growing evidence linking faith with health and well-being, national leaders noted the need to explore the mechanism underlying these linkages. The goal of this prospective study was to investigate the psychosocial mechanisms involved in the preoperative use of private prayer for coping and the effects of such act on short-term quality of life (SPQOL) in 294 patients following open-heart surgery. Using established instruments, three interviews were conducted with middle-aged and older patients (average age 62) at two weeks and two days preoperatively, then 36 days postoperatively. The endpoints were assessed with levels of distress (e.g., depression and anxiety) and fatigue symptoms. Structural equation modeling was used to test a theoretical model. The final model showed the indirect influence of using prayer for coping on SPQOL through the mediation of cognitive coping and perceived social support. However, this mediation was not observed for behavioral, anger, and avoidant coping. Psychosoci...
TL;DR: The recognition of aged abuse in an acute and subacute hospital setting has implications for effective management and community linkage as well as strengthening the knowledge base of issues related to this vulnerable group.
Abstract: Aged abuse can manifest as physical harm, sexual assault, intimidation, blackmail, and social deprivation, misappropriation of funds or property, and neglect. The extent of the problem is difficult to assess in health settings due to underreporting and the fragility and reluctance of the elderly in being able to discuss the issue with health care providers. This appears to be related to the fact that perpetrators are frequently family members with resulting issues of aged dependency, family loyalty, and fear of the consequences of reporting. Of equal importance is a general lack of community understanding of aged abuse, including health professionals who frequently lack the confidence in screening and management to respond appropriately when aged abuse is suspected. Staff knowledge and skills emerge as a deficit in the detection of elder abuse and staff education has been identified as an effective means of improving the recognition of the abused elderly person in acute hospital settings. In addition, the...
TL;DR: In this article, a qualitative research project sought to understand the ED experiences of men with a history of suicidal behavior and substance abuse and those of the emergency personnel who work with them.
Abstract: Care of clients with mental health and substance abuse problems accounts for a significant proportion of all emergency department (ED) visits. This qualitative research project sought to understand the ED experiences of men with a history of suicidal behavior and substance abuse and those of the emergency personnel who work with them. Understanding the unique positions of care providers and this client population in the ED setting can assist the social worker to advocate for this highly vulnerable group of clients and to assist an interprofessional team to develop better crisis interventions.
TL;DR: The implications for women's welfare of policy initiatives relating to care of elderly disabled, including improving services to family caregivers, assuring social financing of formal care, raising local provisions to a national standard, and supporting women's return to the labor force after a period of caregiving are discussed.
Abstract: Caregiving issues are important for industrialized societies that have been undergoing population aging. In this article we consider caregiving as a factor in the outlook for midlife and older women with respect to economic security and economic advancement. We use demographic and economic data from the United States, France, Sweden, and the United Kingdom, in particular to document the importance of continued labor force participation for older women to make ends meet in an era of high household costs of physician services, prescription drugs, and other health-related services, and uncertainties about pensions. Data on employment status, industry, and occupation of economically active women in comparison with men indicate the extent of both gender gaps and progress affecting women's resources. The research of Dr. Myrna Lewis was a stimulus to the present exploration. Our conclusion discusses the implications for women's welfare of policy initiatives relating to care of elderly disabled, including improving services to family caregivers, assuring social financing of formal care, raising local provisions to a national standard, and supporting women's return to the labor force after a period of caregiving. In the context of population aging and longevity, such initiatives are responsive to women's need for earned income to attain retirement security.
TL;DR: The article examines aspects of cultural sensitivity and competence in service development and engagement and identifies service qualities and characteristics social workers can incorporate into practice and programs to increase the likelihood of successful engagement and treatment adherence.
Abstract: This article reviews social work challenges in treatment engagement of men who have sex with men (MSM) and details issues co-morbidity creates for reaching HIV-positive MSM engaged in substance abuse. The literature reviewed within the article identifies HIV and substance use risk factors influencing out of care dynamics and examines relevant research identifying contextual and cultural factors central to achieving cultural competence. The article examines aspects of cultural sensitivity and competence in service development and engagement and identifies service qualities and characteristics social workers can incorporate into practice and programs to increase the likelihood of successful engagement and treatment adherence.
TL;DR: The significant correlations found support further research to identify interventions to help vulnerable, older adults challenge self-perceived capabilities so that they may achieve optimum functionality through increased physical activity earlier on, and increased self-efficacy to support successful adaptation to aging-related losses.
Abstract: An ex post facto analysis of a secondary dataset examined relationships between physical frailty, depression, and the self-perceived domains of health status and quality-of-life in older adults. The randomized sample included 992 community-dwelling, chronically ill, and functionally impaired adults age 65 and older who received care from a Southern California Kaiser Permanente medical center between 1998 and 2002. Physical frailty represents a level of physiologic vulnerability and functional loss that results in dependence on others for basic, daily living needs (Fried et al., 2001). The purpose of the study was to identify possible intervention junctures related to self-efficacy of older adults in order to help optimize their functionality. Multivariate correlation analyses showed statistically significant positive correlations between frailty level and depression (r = .18; p = < .05), number of medical conditions (r = .09; p = < .05), and self-rated quality-of-life (r = .24; p = < .05). Frailty level s...
TL;DR: Nursing staff's abilities to provide patient satisfaction feedback to medical social workers in such areas as responsiveness to patient requests and the satisfaction of patients and their family members with the social services provided are illustrated.
Abstract: For various reasons, the role of the medical social worker is often unclear to persons seeking medical treatment. Allied health professionals, such as nursing staff, tend to have a better understanding of the medical social worker's role and of whether services are being provided to best meet each patient's needs. We aimed to illustrate the abilities of nursing staff to provide patient satisfaction feedback to medical social workers in such areas as responsiveness to patient requests and the satisfaction of patients and their family members with the social services provided. Use of this satisfaction measurement technique will hopefully resolve any confusion that patients, and others not familiar with the role of the medical social worker, may have. This method provides accurate measurement of patients' evaluation of medical social work services.
TL;DR: The importance of cultural relevancy and appropriateness in the design and implementation of effective cancer screening programs for low-income and medically underserved Chinese men and women was highlighted.
Abstract: The purpose of this exploratory study was to assess the health care and cancer screening experience of Chinese immigrants in New York City and identify health care delivery system barriers to cancer education and screening activities. A qualitative, exploratory research methodology based on a grounded theory approach was used. Thirty-nine low-income and medically underserved Chinese men and women participated in 4 focus group sessions and 14 in-depth interviews. Findings revealed numerous barriers experienced by participants: red tape and bureaucracy in the health care system, provider insensitivity to their concerns, lack of availability in doctor schedule, long waiting time in clinics, and fragmentation of the medical care system. This study highlighted the importance of cultural relevancy and appropriateness in the design and implementation of effective cancer screening programs for this population.