The value that social workers' competencies add to health care: An integrative review.

Health and social care professionals' competencies have traditionally been separated because of the different aims of the two professions. These competencies need to be integrated, to make sure that seamless services are provided that meet the often complex needs of patients and clients in a coordinated and timely way. The aim of this integrative review was to identify, describe and synthetise previous studies on integrated competencies in health and social care. Electronic literature searches were carried out on the CINAHL, ProQuest, PsycInfo, PubMed, Scopus and SocIndex databases for peer-reviewed scientific papers that were published in English between 1 January 2007 and 31 December 2019. This identified 3,231 papers, after duplicates were removed, and 18 focused on the integration of social workers' competencies with health care. Other types of integration were not found. The value added by integrating social workers' competencies with health care focused on engaging working orientation, improving communication with family members, increasing understanding of service resources and mastering successful discharge procedures so that they met comprehensive, complex health and well-being needs. Social workers added value when they worked with multi-professional teams, but there were challenges to integrating competencies and these were related to professional collaboration and fragmented leadership. In future, more attention needs to be paid to diversifying and optimising the integration of professional health and social care competencies that meet clients' and patients' care and service needs. It is also vital to focus on developing the professional and leadership strategies that are needed to combine those competencies.

The physical, social and symbolic environment supporting the well-being of home-dwelling elderly people.

OBJECTIVES: The purpose of this study was to construct a theory on an environment that would support the well-being of home-dwelling elderly people in northern Finland. STUDY DESIGN: The study was carried out according to the phases of theory formulation using both qualitative and quantitative methods. METHODS: The data of the first phase consisted of focused interviews (n=39) with home-dwelling elderly people over the age of 65 years. Judgement-based snowball sampling was used. By means of inductive concept synthesis, hypothetical models were constructed of a physical, social and symbolic environment that would support the well-being of the elderly. In order to verify the concepts of the hypothetical model, an instrument was constructed in the second phase of the study and its reliability was evaluated by a panel of experts consisting of nurses (n=15), through expert evaluations (n=3) and by postal questionnaire. The final phase of the study (n=328) also targeted home-dwelling elderly people living in northern Finland. The sampling method used was a stratified random sampling. The data of (n=328) were analysed by principal component analysis (PCA) and confirmatory factor analysis (CFA). RESULTS: The physical environment that supports the well-being of the elderly includes a northern environment, an environment that enables safe activity and a pleasant physical environment. The social environment that supports well-being enables the elderly to receive help, allows them to keep in contact with family members and friends as providers of support to their well-being and offers a pleasant living community. The symbolic environment that supports well-being consists of the ideal attributes of well-being, spirituality, the normative attribute of well-being and a sense of history. CONCLUSIONS: Even though the environment is artificially divided into separate areas in the theory, in putting the results into practice, it needs to be taken into account that observing separate areas of the environment does not provide a comprehensive view on the connection between environment and well-being.