mHealth based intervention by social care professionals to support family caregivers to persons with dementia living at home in Sweden (Caregiver Connect): a randomized controlled trial.

BACKGROUND: The majority of persons with dementia in Sweden reside in their own homes with support from family members. Approximately, 12% of persons with dementia have immigrant background. Within the next 20 years, the number of persons with dementia who are non-ethnic Swedes is said to double. Family caregivers with immigrant backgrounds are noted to receive less support in the community than ethnic Swedes and rate their health status lower than ethnic Swedish peers. The Swedish National Board of Health and Welfare have highlighted the importance of follow-up support for family caregivers with immigrant backgrounds as there is a recognized gap in research and available information tailored to meet the needs of this group. PURPOSE OF THE STUDY: The purpose of the study is to test effectiveness of an mHealth based intervention through which community social workers can improve caregiving competence of non-European immigrant family caregivers of people with dementia living at home in Sweden. The overarching aim is to reduce caregiver burden and depressive symptoms, and improve quality of life. METHODS: A randomized controlled trial (RCT) including wait list control group will be performed consisting of an intervention group (A, n = 44) and a wait list control group (B, n = 44), totaling a sample size of 88. On completion of the 10-weeks long intervention in the intervention group, the intervention will be delivered to group B. Effect of the intervention will be analyzed between and within groups over time. The content of the educational component of the intervention is inspired by the iSupport manual developed by the World Health Organization. The contents, in the form of a booklet, aims to equip the family caregivers with structured information on understanding dementia as a condition and its management at home, including self-care guidance designed specifically for family caregivers themselves. DISCUSSION: Similar telephone-delivered intervention studies targeted for family caregivers to persons with dementia are ongoing in Malaysia and will start in India using the same booklet adapted to the local context. These studies will provide evidence on the effectiveness of using digital technologies to deliver support to those who may not be reached or adequately served by the traditional healthcare system. TRIAL REGISTRATION: ISRCTN registry, Registration number ISRCTN64235563.

Challenges perceived by social workers to prevent FGM/C in Bavaria: a prospective, cross-sectional survey.

BACKGROUND: Worldwide, at least 230 million girls and women are affected by female genital mutilation/ cutting (FGM/C). FGM/C violates human rights and can cause irreparable harm and even lead to death. In 2022, more than 100,000 survivors of FGM/C lived in Germany, and more than 17,000 girls were considered at risk. Due to the increasing number, there is a need to improve the skills of professionals not only to treat FGM/C but also to prevent it, aiming to maintain or improve women's physical and mental health. However, previous studies mostly focused on health care providers, even though other professionals such as social workers, play an important role in the provision of sexual and reproductive health (SRH) care and are often the first point of contact. Therefore, the study's main objective was to understand challenges perceived by social workers in pregnancy counselling centres in the provision of good quality of SRH care for girls and women suffering from or endangered by FGM/C. METHODS: A quantitative self-administered cross-sectional online survey was sent by e-mail in 2021 to all pregnancy counselling centers in the German federal state of Bavaria. RESULTS: Among the 141 participants, 82% reported no or insufficient FGM/C knowledge and barriers to provide the best quality of care. The main findings were language obstacles (82.7%), perceived client's fear or shame (67.9%) and cultural difficulties (45.7%). Furthermore, participants also reported a lack of competence on the professional side (29.6%). Importantly, most participants (129 of 141; 92%) expressed interest in training. CONCLUSION: Providing comprehensive good quality sexual and reproductive health care to women and girls affected from or endangered by FGM/C is challenging. The study revealed the importance of strengthening the skills of social workers and suggested the following strategies: (1) enhancing FGM/C knowledge and skills (including specialized competences e.g., in mental health) by improving training and information material for the target group, (2) improving referral pathways and addressing deficits in the existing care system (e.g. with health or legal institutions), and (3) developing trusting relationships with cultural (or traditional) mediators to build strong community networks.

Triggers and factors associated with moral distress and moral injury in health and social care workers: A systematic review of qualitative studies.

OBJECTIVE: At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action, as it aligns with their own values; a phenomenon known as moral distress. Similarly, there are increasing reports of healthcare workers experiencing long-term mental and psychological pain, alongside internal dissonance, known as moral injury. This review examined the triggers and factors associated with moral distress and injury in Health and Social Care Workers (HSCW) employed across a range of clinical settings with the aim of understanding how to mitigate the effects of moral distress and identify potential preventative interventions. METHODS: A systematic review was conducted and reported according to recommendations from Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were conducted and updated regularly until January 2024 on 2 main databases (CENTRAL, PubMed) and three specialist databases (Scopus, CINAHL, PsycArticles), alongside hand searches of study registration databases and other systematic reviews reference lists. Eligible studies included a HSCW sample, explored moral distress/injury as a main aim, and were written in English or Italian. Verbatim quotes were extracted, and article quality was assessed via the CASP toolkit. Thematic analysis was conducted to identify patterns and arrange codes into themes. Specific factors like culture and diversity were explored, and the effects of exceptional circumstances like the pandemic. RESULTS: Fifty-one reports of 49 studies were included in the review. Causes and triggers were categorised under three domains: individual, social, and organisational. At the individual level, patients' care options, professionals' beliefs, locus of control, task planning, and the ability to make decisions based on experience, were indicated as elements that can cause or trigger moral distress. In addition, and relevant to the CoVID-19 pandemic, was use/access to personal protection resources. The social or relational factors were linked to the responsibility for advocating for and communication with patients and families, and professionals own support network. At organisational levels, hierarchy, regulations, support, workload, culture, and resources (staff and equipment) were identified as elements that can affect professionals' moral comfort. Patients' care, morals/beliefs/standards, advocacy role and culture of context were the most referenced elements. Data on cultural differences and diversity were not sufficient to make assumptions. Lack of resources and rapid policy changes have emerged as key triggers related to the pandemic. This suggests that those responsible for policy decisions should be mindful of the potential impact on staff of sudden and top-down change. CONCLUSION: This review indicates that causes and triggers of moral injury are multifactorial and largely influenced by the context and constraints within which professionals work. Moral distress is linked to the duty and responsibility of care, and professionals' disposition to prioritise the wellbeing of patients. If the organisational values and regulations are in contrast with individuals' beliefs, repercussions on professionals' wellbeing and retention are to be expected. Organisational strategies to mitigate against moral distress, or the longer-term sequalae of moral injury, should address the individual, social, and organisational elements identified in this review.

Discharge process for patients experiencing homelessness in the emergency department: A thematic qualitative study.

People experiencing homelessness are more likely to utilize emergency departments than their non-homeless counterparts. However, obtaining a bed in a homeless shelter for patients can be complex. To better understand the challenges of finding a safe discharge plan for homeless patients in the emergency department, our team conducted interviews with emergency department social workers and homeless shelter case managers in the Boston area. We identified and mapped the stages in the processes performed by both parties, identifying challenges with successful placement into a shelter. Furthermore, we assembled a data dictionary of key factors considered when assessing a patient's fit for a homeless shelter. By identifying bottlenecks and areas of opportunity, this study serves as a first step in enabling homeless individuals to receive the post-discharge assistance they require.

At the Forefront: Social Workers' Role in Psilocybin Treatment for Depression and Substance Misuse.

This article underscores the critical role of social workers in harnessing the potential therapeutic benefits of psilocybin for treating major depressive disorder (MDD) and substance use disorder (SUD). Contemporary treatments for MDD often have side effects, and the success rate for SUD treatments remains low. The pervasiveness of MDD, combined with the challenges in treating SUD, highlights a need for innovative treatments. This article provides an overview of the resurgence of literature over the past two decades that illuminates the therapeutic promise of psilocybin for mental health treatment; clinical trials elucidate the efficacy of psilocybin-assisted therapy in mitigating MDD and demonstrate great promise in reducing SUD symptoms. The long-lasting posttreatment effect emphasizes its potential as a novel treatment modality. Furthermore, psilocybin's recognition as a "breakthrough therapy" by the U.S. Food and Drug Administration (FDA) and the accelerating pace of psychedelic reform bills indicate growing acceptance and interest in its therapeutic capacities. Psilocybin-assisted therapy emerges as a potent treatment option, showcasing remarkable effectiveness even after a single dose. Recommendations and pathways for social workers to be involved in psilocybin-assisted therapy investigation, advocacy, and implementation are provided.

Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio.

BACKGROUND: Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations. METHODS: Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis. RESULTS: Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life. CONCLUSIONS: Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.

Priorities for enhancing nurses' and social workers' competence and confidence in helping families support dependent children through parental death. A classic-Delphi survey.

BACKGROUND: Annually, approximately five per cent of dependent children - aged under eighteen years - in the United Kingdom (UK), experience parental death. Nurses and social workers caring for parents with life-limiting illnesses, including cancer, help families support their children. However, these professionals have been found to lack confidence and competence in fulfilling this role. METHODS: We conducted three rounds of a classic-Delphi survey to identify and measure a panel of topic experts' consensus on the priorities and issues for nurses and social workers when supporting families and children through parental death. The Delphi survey was conducted with a panel of UK topic experts (n=43) including lead health and social care professionals (n=30), parents bereaved of a partner whilst parenting dependent children (n=6), academics (n=4) and bereaved young adults (n=3). RESULTS: Ninety per cent (n=18/20) of the issues for nurses and social workers and all (7/7) of the priorities rated and ordered in the survey achieved consensus. Key priorities were 1) training in opening conversations with families about dependent children, 2) training and support for nurses and social workers to manage their own and others' emotions arising from conversations with parents about children's needs regarding parental death, and 3) increasing nurses' and social workers' knowledge of sources of information to support families before the death of a parent. CONCLUSION: We identified priorities for UK nurses and social workers. Further research is needed to identify which of these nurses and social workers would benefit most from support, and how any resultant interventions could enhance confidence and competence in helping families to support children through parental death.

Outcomes of Aggression and Victimization in Social Welfare Services.

This study examined two significant phenomena that occur in the workplace, aggression and victimization, and their outcomes. The study's participants were 470 social workers employed by social welfare services in Israel. The examined outcomes were stress symptoms, emotional exhumation, and decline in quality of service climate. The associations between aggression, victimization, and their outcomes were examined via linear regression during Stata 14. The study found that the similar outcomes of aggression and victimization are stress symptoms and emotional exhaustion, while service climate (decline in quality) was associated only with victimization. While most studies have examined mainly victimization outcomes, the current study examined both aggression and victimization outcomes. This article sheds light on the similarities and the difference of outcomes between aggression and victimization and explicates the phenomena of workplace aggression from two important and complementary aspects of aggression and victimization. It is important to refer to either aggression or victimization while considering workplace aggression. Authors recommend for further studies to continue to investigate both aggression and victimization while researching workplace aggression outcomes.

Social Work Responses to the COVID-19 Pandemic in Nepal: Current Practices and Future Considerations.

This paper examines the findings of a small qualitative study focusing on two virtual discussions facilitated by the Social Workers' Association Nepal (SWAN) in May and June 2020 and follow-up interviews conducted with the participants during June 2020. The aim of these discussions and follow-up interviews was to examine the role of social workers in responding to the COVID-19 pandemic in Nepal. Seven social work practitioners (including Master's of Social Work graduates (n = 3), PhD student (n = 1), and social work practitioners (n = 3)) from across the country participated as invited speakers in the sessions with approximately 500 Nepalese social workers engaged as voluntary participants. Based on these discussions, a process of thematic analysis was utilized, where a series of findings emerged that gave consideration to the role of social workers in assisting Nepalese civil society in responding to the COVID-19 pandemic. These findings centered upon nationwide action including: emergency responses, relief goods coordination and distribution, quarantine management, psychosocial support, and infodemic management administered by social work practitioners. A series of recommendations emerging from the study's findings serve to inform the central role of social workers in responding to the current pandemic in Nepal.

Social Workers' Perceptions Regarding Legal Intervention for Older Adults without Significant Cognitive Decline Who Are Abused by Their Adult Child.

Social workers aiding older adults facing abuse from their adult child confront an ethical dilemma: whether to honor autonomy or prevent harm. The study explores how social workers perceive legal intervention against the older adult's will. Twenty-one aging-specialized social workers took part in semi-structured interviews using a vignette. The analysis was conducted inductively, guided by content analysis principles. Two main themes emerged, focusing on the disadvantages and benefits of legal intervention. The findings underscore that combining teleological and deontological considerations could form a foundation for developing decision-making tools to aid social workers in navigating this dilemma effectively.

Social Workers' Perspectives on Socially Isolated Older Adults Living with a Robot Companion.

Addressing depression and social isolation among solo-living older adults in South Korea requires a multi-faceted approach. This study aims to explore the advantages and obstacles of a robotic elder care program by analyzing social workers' viewpoints regarding interactions between older adults and a companion robot named Hyodol. Through the purposive sampling method, we conducted comprehensive interviews with 10 social workers who are pioneering the integration of robots in elder care. The study participants observed and compared the demographic characteristics of users and non-users, elucidated usage patterns, described the roles of robot companions, and shared remarkable instances. Overall, the experiences of these social workers underscored the positive influence of Hyodol in offering companionship, care, and emotional support, especially in circumstances where clients experienced isolation or lacked regular family interactions. In addition, social workers' perspectives hold significant value in comprehending the genuine effects of anthropomorphism - the inclination to attribute human-like qualities and emotions to robots. Our investigation revealed the existence of two distinct modes of personification among older adults, which we have labeled as "imagination" and "projection."

Determinants of psychological injury among health and social care workers in community settings: A systematic review.

BACKGROUND: Health and Social Care (HSC) workers face psychological health risks in the workplace. While many studies have described psychological injuries in HSC workers, few have examined the determinants. Previous research has primarily focused on hospitals, lacking systematic reviews of community-based settings. OBJECTIVE: To systematically identify and appraise current evidence on the determinants of psychological injuries among HSC workers in community settings. METHODS: Searches were conducted in three bibliographic databases, supplemented by citation searches. Included studies focused on community-based HSC workers, reporting statistical associations between psychological injury and personal, health, occupational, or organizational factors. Quantitative studies published in English between January 1, 2000 and August 15, 2023 were included. Quality appraisal was undertaken using the JBI critical appraisal checklist. RESULTS: Sixty-six studies were included. Study quality was highly variable, and all studies were cross-sectional. Twenty-three studies linked psychological injury with occupational factors (e.g. low job control, high job demands and low job satisfaction). Thirteen studies observed an association between work environment and psychological injury, and a further eleven between workplace social support and psychological injury. Fewer studies have examined the relationship between psychological injury and personal/individual factors. CONCLUSION: Occupational and organisational factors are significantly associated with psychological health among HSA workers, in community settings. These aspects of job design, work environment and workplace relationships are modifiable, suggesting an opportunity for work design interventions to improve workers' psychological health and reduce the prevalence of psychological injury in this sector.

Educating Social Workers in Palliative and End-of-Life Care: Development and Implementation of a New National Training Program.

Background: Educating Social Workers in Palliative and End-of-Life Care (ESPEC) is a nationally scalable continuing education program designed to improve the knowledge and skills of frontline health social workers caring for patients with serious illness. Objectives: This article describes ESPEC's rationale, development, and initial implementation. Design: Following the creation of consensus-derived core primary palliative care competencies for health primary care social workers based on the eight domains of palliative care outlined in the National Consensus Project Guidelines for Quality Palliative Care, an evidence-based curriculum was developed. This was used to develop a hybrid training model with a self-study component, synchronous instructor-led skills-based training, leadership training, and mentorship. The interactive curriculum incorporates patient scenarios highlighting the health social work role. Training targets high-impact skills-the biopsychosocial-spiritual assessment, advance care planning, family meetings, and interprofessional communication-and professional development. Settings/Subjects: ESPEC was launched in the United States in collaboration with the National Association of Social Workers (NASW) and the Social Work Hospice and Palliative Care Network (SWHPN). Results: The preliminary launch demonstrated high user acceptability, positive ratings for content and format, and gains in knowledge and competence. Conclusions: Data suggest that ESPEC can increase health social workers' knowledge and confidence as providers of palliative care interventions. National dissemination is ongoing.

Examining Strategies among Veterans Affairs Outpatient Social Workers to Facilitate Job Retention and Emotional Well-Being during the COVID-19 Pandemic.

The social work profession is dealing with an increased rate of turnover, due largely in part to the pandemic. A recent study showed that U.S. Department of Veterans Affairs (VA) inpatient social workers utilized strategies of "emotional preparedness" to retain their job during the pandemic. The aim of this current study is to explore if outpatient social workers utilized similar strategies for their own job retention. There may be differences in the strategies utilized because outpatient and inpatient social workers tend to work in different environments. In this qualitative study, authors conducted interviews with (N = 13) outpatient social workers from a VA site in the Southwestern region of the United States. Findings were analyzed thematically. Authors conducted open coding and applied a priori themes/strategies from extant research among VA inpatient social workers. Most of the a priori themes/strategies were prevalent among outpatient social workers, and two emerging themes were (1) acknowledging shared trauma and (2) human connection to overcome isolation. Strategies of emotional preparedness should be implemented on a grander scale to facilitate job retention since there is an expected deficit in the social work workforce until at least 2030.

Implementing psychological support for health and social care staff affected by the COVID-19 pandemic: a qualitative exploration of staff well-being hubs ('Resilience Hubs') using normalisation process theory.

OBJECTIVES: Evaluate the implementation of Hubs providing access to psychological support for health and social care keyworkers affected by the COVID-19 pandemic. DESIGN: Qualitative interviews informed by normalisation process theory to understand how the Hub model became embedded into normal practice, and factors that disrupted normalisation of this approach. SETTING: Three Resilience Hubs in the North of England. PARTICIPANTS: Hub staff, keyworkers who accessed Hub support (Hub clients), keyworkers who had not accessed a Hub, and wider stakeholders involved in the provision of staff support within the health and care system (N=63). RESULTS: Hubs were generally seen as an effective way of supporting keyworkers, and Hub clients typically described very positive experiences. Flexibility and adaptability to local needs were strongly valued. Keyworkers accessed support when they understood the offer, valuing a confidential service that was separate from their organisation. Confusion about how Hubs differed from other support prevented some from enrolling. Beliefs about job roles, unsupportive managers, negative workplace cultures and systemic issues prevented keyworkers from valuing mental health support. Lack of support from managers discouraged keyworker engagement with Hubs. Black, Asian and minority ethnic keyworkers impacted by racism felt that the Hubs did not always meet their needs. CONCLUSIONS: Hubs were seen as a valuable, responsive and distinct part of the health and care system. Findings highlight the importance of improving promotion and accessibility of Hubs, and continuation of confidential Hub support. Policy implications for the wider health and care sector include the central importance of genuine promotion of and value placed on mental health support by health and social care management, and the creation of psychologically safe work environments. Diversity and cultural competency training is needed to better reach under-represented communities. Findings are consistent with the international literature, therefore, likely to have applicability outside of the current context.

Social Workers' Experiences of Support in the Workplace during the COVID-19 Pandemic.

This qualitative study included in-depth semistructured interviews with 17 social workers from across the state of Texas that took place during the summer of 2021. The purpose of this study was to describe social workers' experiences of workplace support during the COVID-19 pandemic and provide implications for how to improve support in the workplace. The interviews were analyzed using a phenomenological approach to describe the main themes of the participants' experiences. The findings combined with current literature suggest that following the pandemic and in the case of similar prolonged disasters organizational leaders should consider supporting their social work staff by clearly communicating protocol changes, providing more autonomy and flexible work arrangements, increasing time off and financial support, and providing tangible assistance such as technological support. Leaders should also consider their social work staff's emotional well-being following the pandemic by providing therapeutic resources and bonding opportunities for staff to promote a more resilient team-like culture in the workplace.

Need for social work interventions in the emergency department.

This paper reports findings from a qualitative study conducted on the Need for Social work interventions in the Emergency Department (ED) at a large tertiary care center in India. The emergency department is an important social work intervention point for individuals with various psychiatric, medical, and social needs who have little or no additional interaction with social services. Social workers are specially trained to understand the impact of social factors on health outcomes and provide interventions that address social barriers to improving health and accessing community resources; social workers are well prepared to provide services in the emergency department. However, limited research is available to understand the impact of psychosocial services in the emergency department. We aimed to identify areas which require integrated social work services and coordination to address the psychosocial issues within the ED. Interviews with 10 healthcare workers are analyzed thematically. Recurring themes throughout the interviews confirm the need for providing social work interventions to ensure the medical, psychological, and social care needs in the emergency department.

The Professional Identity of Social Workers in Mental Health Services: A Scoping Review.

Recent research into the role of mental health social work has identified a need for increased critical engagement with accounts of professional role and identity. Notably, a number of studies have found that social workers struggle to articulate their role within mental health teams and services. This study aimed to identify the ways in which social workers in mental health settings defined their professional identity and role. An international scoping review utilizing Arksey and O'Malley's method was conducted, identifying 35 papers published between 1997 and 2022. A thematic analysis grouped the findings into three predominant themes: (i) distinct social work approaches to mental health, (ii) organizational negotiations for mental health social workers, and (iii) professional negotiations for mental health social workers. These thematic findings are discussed in relation to existing research and critical perspectives, with particular emphasis on accounts of the bureaucratic and ideological functioning of professionalism in mental health services, as well as the global direction of mental health policy. This review finds that mental health social work embodies a coherent identity that aligns with international mental health policy agendas but faces significant challenges in developing and expressing this identity within mental health services.

Race and COVID-19 among Social Workers in Health Settings: Physical, Mental Health, Personal Protective Equipment, and Financial Stressors.

Social work is an essential workforce integral to the United States' public health infrastructure and response to COVID-19. To understand stressors among frontline social workers during COVID-19, a cross-sectional study of U.S-based social workers (N = 1,407) in health settings was collected (in June through August 2020). Differences in outcome domains (health, mental health, personal protective equipment [PPE] access, financial stress) were examined by workers' demographics and setting. Ordinal logistic, multinomial, and linear regressions were conducted. Participants reported moderate or severe physical (57.3 percent) and mental (58.3 percent) health concerns; 39.3 percent expressed PPE access concerns. Social workers of color were more likely to report significantly higher levels of concern across all domains. Those identifying as Black, American Indian/Alaska Native (AIAN), Asian American/Pacific Islander (AAPI), multiracial, or Hispanic/Latinx were over 50 percent more likely to experience either moderate or severe physical health concerns, 60 percent more likely to report severe mental health concerns, and over 30 percent more likely to report moderate PPE access concerns. The linear regression model was significantly associated with higher levels of financial stress for social workers of color. COVID-19 has exposed racial and social injustices that that hold true for social workers in health settings. Improved social systems are critical not just for those impacted by COVID-19, but also for the protection and sustainability of the current and future workforce responding to COVID-19.

Supervision Effects on Negative Affect and Psychological Distress: Evidence from Social Workers in China.

Supervision is an imperative practice within the social work field. It provides social workers with support systems, ensures that social workers are adhering to professional standards, and protects clients. Research has also shown that quality supervision can improve social workers' professional capacity and reduce work stress. However, most of this research has been confined to social workers' experiences within Western countries and has been largely qualitative in nature. Thus, this study aims to examine the experience of 489 social workers based in Guangzhou, China to understand how supervision affects their negative affect and psychological distress. The findings indicate that supervision not only reduces negative affect and psychological distress amongst Chinese social workers, but also is especially effective for social workers with high job demands. When job demands are high, social workers who receive both individual and group supervision also appear to have lower negative affect and psychological distress as compared to social workers who only receive individual supervision. These findings emphasize the significance of supervision as a buffer factor to reduce negative affect and psychological distress amongst Chinese social workers who face high job demands.