Search

This paper reports findings from a qualitative study on the triggers of hospital social workers' moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual's personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal hospital policies; and organizational values, such as perceptions of institutional support and validation. Implications of this research suggest that health systems need to foster positive ethical environments that nurture clinicians' health and mental health through programs that aim to increase moral resilience, promote empowerment, and foster wellness. [ABSTRACT FROM AUTHOR]

The present study offers a nuanced understanding of the ways that adolescents in collectivist cultural contexts experience and develop their purpose engagement. We adopted a person-centered approach to categorize 450 Chinese adolescents into clusters based on their similarities on the dimensions of purpose exploration and commitment. Consistent with expectations, we found that adolescents with Achieved profiles were the most adaptive among all: they had the highest scores as to personal characteristics (e.g., hope, prosocial tendency, self-efficacy), highest parental support (e.g., parent–child attachment, autonomy facilitation, emotional support), highest life satisfaction, and lowest depressive emotions scores. Conversely, adolescents with Diffused profiles were the least adaptive. Adolescents with Uncommitted and Foreclosed profiles scored between those of Achieved and Diffused groups and, surprisingly, did not differ in most variables. Overall, the demonstrated linkages between purpose profiles, personal characteristics, parental support, and psychological adjustment have important implications for parents and adults who work with adolescents. [ABSTRACT FROM AUTHOR]

Sexual dysfunction is very commonly reported by people with multiple sclerosis (MS). However, this problem often remains under-diagnosed and under-treated. Furthermore, still very little is known about protective psychosocial factors that may help to improve sexual functioning in MS patients. Thus, we aimed to assess the associations between social support, self-esteem and sexual functioning in MS patients when controlled for clinical and sociodemographic variables. The Expanded Disability Status Scale (EDSS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Rosenberg Scale of Self-esteem (RSE) were used to assess the independent variables. Sexual functioning was assessed by the Incapacity Status Scale (ISS). We found a significant association between social support and sexual functioning (p = 0.01). However, this association attenuated (p < 0.05) when self-esteem (p < 0.01) was added to the model. Furthermore, we found that sexual dysfunction in MS patients was associated with older age (p < 0.001). Self-esteem was associated with sexual functioning more strongly compared to social support and sexual functioning, even though both of these variables were associated with sexual functioning as well. Our findings support the biopsychosocial model of treatment of sexual dysfunction in MS patients. [ABSTRACT FROM AUTHOR]

Recent mental health policy endorses a personal recovery framework that focuses on individual purpose and meaning. Therefore, psychology pre-registration training needs to promote knowledge and attitudes that are aligned with this framework.The 5 + 1 training pathway was recently established in Australia and emphasises readiness for practice. This study examined how provisional psychologists undertaking the 5 + 1 pathway perceived recovery. Semi-structured interviews were completed with nine provisional psychologists completing the coursework component of the 5 + 1 pathway. Interviews focused on perspectives of recovery and were analysed with thematic analysis. Three themes related to perspectives of (i) recovery as a process that involved building capacity to undertake key life roles, (ii) ways that psychologists can promote recovery through their stance and their practices and (iii) factors that have influenced participants' views of recovery. The findings indicate that provisional psychologists in the 5 + 1 pathway are able to develop appropriate but limited perspectives that are generally consistent with the personal recovery framework. Participants were more influenced by client contact than coursework. Learning about recovery could be enhanced by explicitly teaching models of recovery and incorporating views of people with lived experience. Key Points What is already known about this topic: Mental health clinicians' attitudes and perspectives of their work have an impact on the nature of the support they provide. Training plays an important role in developing psychologists' attitudes and perspectives towards recovery. The 5 + 1 internship is a recently established training pathway to registration as a psychologist. What this paper adds: This paper reports on one of few studies related to the Australian 5 + 1 training pathway for psychologists. Although unfamiliar with formal models of recovery, students' perspectives were mostly consistent with personal recovery but there were some indications of conceptual confusion. Recommendations are made for extending development of students' perspectives of recovery. [ABSTRACT FROM AUTHOR]

Supervisors of human service organizations can support violence prevention or contribute to experiences of workplace violence. This qualitative study sought to explore the ways in which supervisors prevent opportunities for workplace violence through their relationships with workers. Interviews with 81 workers in publicly administered human services in a Canadian province were analyzed using qualitative techniques. Results show that supervisor attentiveness, supervisor support, involvement by one's supervisor, and treating workers equally all contributed to workplace violence prevention. Findings provide important practical considerations that detail how supervisors play a critical role in supporting health and safety in human service workplace environments. [ABSTRACT FROM AUTHOR]

Family caregivers (FCs) of persons with mental illness (PMI) often experience caregiving burdens that contribute to poor mental health. As compared to European-American FCs, Asian-American FCs may experience greater caregiving burden due to an increased likelihood of cohabiting with PMIs. Yet, limited research exists on the caregiving experience of Asian-American FCs and on how self-care practice and social support mediate caregiver burden among FCs of PMIs. Using a cross-sectional mixed-method design this study explored the impact of caregiving burden on mental health outcomes among Chinese-American and European-American FCs. The quantitative data showed similar caregiving burden between the two groups and a partial mediation role for self-care practice on FCs' mental health. The qualitative data showed that FCs from the two groups utilized different types of social support. Findings suggest the need for mental health professionals to develop intervention programs to enhance self-care practices and social support for FCs when working with PMIs. [ABSTRACT FROM AUTHOR]

Vicarious trauma is a predictable side effect of social work practice with growing evidence of its varied impact on individuals and workplaces. Organisations employing social workers do not always take a preventative or proactive approach to addressing vicarious trauma, often assuming the provision of supervision and encouraging worker self-care will be sufficient. This article argues that organisations should be encouraged to accept responsibility for addressing vicarious trauma as a work health and safety issue. A narrative literature review of studies and articles over the last 10 years is presented that identified individual or organisational strategies to reduce the risk of vicarious trauma. The authors encourage individual social workers, social work managers, and organisations employing social workers to consider their approach in light of these findings, as well as wish to encourage further research. [ABSTRACT FROM AUTHOR]

Providing care can be demanding and is associated with increased financial, emotional and psychological distress. Relatives of individuals with At-Risk Mental State (ARMS) of psychosis provide significant emotional, practical and economic support but are often a neglected group. The current study aimed to investigate the barriers and facilitators for those supporting ARMS individuals. Semi-structured interviews with fourteen family members from the Individual and Family Cognitive Behavioural Therapy (IFCBT) trial were conducted. Key barriers included relatives' unmet needs and limited confidence accessing and providing support. Facilitating factors included open communication with the individual, flexible, understanding employers and feeling that they themselves were supported. Those who identify multiple barriers may have increased levels of worry and distress that negatively impact their own health and wellbeing. Services in contact with ARMS individuals should provide families support to sustain an adequate level of care, including psychoeducation around the individual's experiences and behaviours, discussions around talking to employers and help exploring more adaptive coping strategies including accessing support from social networks. Clinical teams and/or family peer-support workers that look to support relatives early in their caregiving journey could help improve outcomes in relative's quality of life and consequently benefit the ARMS individual. [ABSTRACT FROM AUTHOR]

Parenting support needs of patients diagnosed with incurable end-stage cancer (IESC) with young families are not addressed as part of routine hospital health care. Their support needs and experiences of hospital-based parenting support are largely unknown. The study aims to explore hospital-based parenting support delivery from patient and co-parent perspectives in context to their parenting experience and support needs. Exploratory, prospective, cross-sectional qualitative design. Semi-structured in-depth interviews with eight adult patients with IESC and four co-parents purposively recruited from a tertiary hospital in Melbourne, Australia. Findings were thematically analyzed. Parents desire support with challenging multidimensional parenting issues. Organization, health professionals (HP), and parental-based factors hinder and facilitate optimal service provision. Responsibility rests with HP to initiate parenting support. Interdisciplinary family-focused support offered throughout IESC health-care journey is key. Patient-centered family-focused support is warranted. Surmountable challenges lie with management and HPs to address barriers affecting optimal service delivery. [ABSTRACT FROM AUTHOR]

The purpose of this article is to examine women's perceptions of the patient-provider relationship in the context of medically high-risk pregnancy (MHRP). Sixteen in-depth interviews were conducted with women hospitalized for MHRP on a maternal-fetal medical unit in the US. Tenets of phenomenology guided the data analysis. We found that beyond normative stress related to managing physical aspects of MHRP, women reported added emotional stressors associated with navigating the fragmented health care environment. This study suggests that improved care coordination and systematic integration of psychosocial professionals within the perinatal interdisciplinary health care team are vital to reduce care-related stressors on this vulnerable patient group. [ABSTRACT FROM AUTHOR]

Background: People with aphasia are at high risk of depression with the majority fulfilling depression diagnostic criteria up to one year post-stroke. There is a lack of psychological care to prevent and treat depression and address the communication disability associated with aphasia. Translating a framework of stepped psychological care after stroke may potentially address treatment gaps and improve rehabilitation outcomes. This multidisciplinary framework is usually composed of level 1 to 4 interventions that match the person's level of need and severity of symptoms. However, the perspectives of people with aphasia regarding stepped psychological care, mood changes, depression and current practice is extremely limited in the research evidence. Aims: To describe, from the perspective of people with aphasia: a) the experience of mood changes, depression and current practice after post-stroke aphasia; and b) preferences within a stepped psychological care approach. Method & Procedures: Ten people with aphasia participated in two semi-structured interviews each, within a maximal variation sample (severity of aphasia, presence or not of possible depression, transition phase of care). Video data from the 20 interviews were transcribed for speech and non-speech communication and analysed using Interpretive Description. Outcomes & Results: All participants self-reported mostly negative mood changes after aphasia whether they were identified as depressed or not on the SADQ10. Three core themes were derived: 1) the onset of stroke and aphasia is a traumatic event resulting in mood difficulties and depression; 2) people with aphasia are trying to work through communication and mood difficulties with limited psychological support and services in stroke rehabilitation; 3) positivity, supported communication and access to individually tailored therapy would be essential to people with aphasia through stepped psychological care. 10 sub-themes were also identified. Conclusions: This study demonstrates that the onset of post-stroke aphasia is traumatic with negative mood changes impacting ability to participate in stroke rehabilitation. Within this context, it was evident that all participants experienced mood changes but had not participated in stepped psychological care in stroke rehabilitation. Some had experienced elements of psychological care. Stepped psychological care is recommended for people with aphasia. [ABSTRACT FROM AUTHOR]

The rising prevalence of long-term conditions (LTCs) is placing increasing pressures on healthcare systems. With the future prospect that more individuals will experience multiple comorbidities, LTCs are becoming a growing concern. This article aims to discuss the challenges faced by and the opportunities afforded to physiotherapists when caring for people with LTCs. It highlights the complexity of managing people with LTCs and the demands faced by physiotherapists when working within a transitioning healthcare service that necessitates cost-effective yet, sustainable care. It considers ways that interventions can be optimized to not only support individuals with LTCs to improve their quality of life, but live an existence that has meaning and purpose. It also explores health promotion strategies that could be influential in changing the future healthcare landscape, by helping to prevent the occurrence of LTCs. The wider intention is to facilitate discussion of the future role of the physiotherapy profession in LTC management, in the hope that a shared vision can be created that is inspiring and transformative. A vision that imagines a physiotherapy service that is resilient to change and contemporary in approach, which continues to evolve to support the changing needs of people with LTCs. [ABSTRACT FROM AUTHOR]

Copyright of Australian Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Often referred to as miscarriage, Early Pregnancy Loss (EPL) is the spontaneous death of a fetus experienced within the first 20 weeks of gestation and is the most common complication in pregnancy. Symptoms of an impending EPL are routinely managed in the Emergency Department (ED). EPL can have a substantial impact on women, potentially leading to psychological and emotional health issues and risks to future pregnancies. Despite the high prevalence of EPL, many women suffer in silence due to the common societal belief that EPL are insignificant. Many women experience EPL as an ambiguous loss and are at risk for disenfranchised grief. Compassionate, patient-centred care has been identified by women as an essential and often missing aspect of ED care and can have a profound impact on the overall well-being of women after EPL. Social workers play a critical role in the ED given that they prioritize the psychosocial well-being of patients in a system that is structured to primarily address trauma care. In an effort to reduce the psychological impact and complicated grief reactions of women experiencing EPL, specific recommendations for social work intervention to address the individual needs of women experiencing EPL in the ED are presented. These include acknowledging the loss, providing psychoeducation, honouring the loss, assessing resources, referral and additional information, and building capacity in the ED. [ABSTRACT FROM AUTHOR]

Cultural-specific determinants of coping with widowhood were investigated by the Two-Track Model of Bereavement. Participants were 93 middle-aged and middle-class Israeli Arab Muslim widows. Factor analysis emitted 4 factors of adjusting to widowhood. The suffering and resilience factors and the total scale score were consistently correlated with personality attributes, whereas demographics were associated mainly with the suffering factor and the total scale score. The factors differed from the factors characteristic of Israeli Jewish bereaved, which emphasize the need to examine models of bereavement in cross-cultural perspective and to account for the interaction of cultural effects with psychological processes. [ABSTRACT FROM PUBLISHER]

Background:This study was the final phase of a participatory design (PD) project aimed at developing professionally led online art therapy groups for young adults with cancer.Methods:We invited seven professionals with a range of relevant expertise to take part in a PD process that emphasized hands-on creative interaction. Each participant experienced one or more online art therapy sessions and provided feedback that we analyzed with qualitative thematic analysis.Results: The analysis yielded six inter-related themes representing three types of experience (comfort, sense of connectedness and expression) and three types of therapeutic action that supported these experiences (facilitation, group support and dialog about the art).Conclusions: The results assured us that our newly developed mode of psychosocial support was ready for online delivery to young adults with cancer. The results provided insight into therapeutic processes in online art therapy groups, especially with regard to collective meaning-making and sense of connection. [ABSTRACT FROM AUTHOR]

This tool is a unique comprehensive scale and methodology to measure the psychosocial acuity of patients and families across a health care continuum. Coupled with other measures, psychosocial acuity can tell a complete and compelling story of social work contributions and aid in resource alignment. Accurately conveying the full scope of social work value to anyone, especially health system leadership, requires that the psychosocial acuity of the patient and family be measured and factored into the equation, along with productivity, time spent, and services provided. The development and utilization of the Psychosocial Acuity Tool is the focus of this publication. [ABSTRACT FROM AUTHOR]

Elderly patients presenting to St. Vincent's Health Emergency Department (ED) constitute approximately one third of presentations. A significant proportion of these involve preexisting conditions including depression that, within elderly patients, is associated with social isolation, physical and mental health problems, and barriers to accessing community services. It is also often overlooked as a clinical diagnosis among the elderly. This study aimed to assess the efficacy of a brief depression screening tool and examine the change over time in quality of life and social factors for elderly patients who present to ED. Patients aged 65 years and over were screened for depression using a short form of the Geriatric Depression Scale (GDS-15). Participants were randomized into control (usual care) and intervention (an assertive outreach community management program) groups and assessed in relation to depression, quality of life, and social support/functioning at recruitment and 6 weeks post discharge. Approximately one in four participants experienced mild to moderate depression that was related to medical factors and associated reduced mobility. This study suggests that an assertive outreach program, with the inclusion of community intervention and links to social supports and services, could improve the management of depression in the elderly and associated health outcomes. [ABSTRACT FROM AUTHOR]

There is a striking absence of literature articulating and evaluating clinical social work contributions to suicide prevention, despite considerable practice in this important field. This article reports on a model of assertive brief psychotherapeutic intervention and facilitated linkage to community services utilized in a prospective cohort study of emergency department suicide attempt aftercare. A key outcome measure, the Manchester Short Assessment of Quality of Life (MANSA), was used with 65 patients to assess psychosocial domains at initial presentation, 4-weeks, 3-months, and 6-months. There were significant improvements in the domains of work, finance, leisure, social life, living situation, personal safety and health by 3 months. There were highly significant correlations between psychosocial improvements and improved depression scores. [ABSTRACT FROM AUTHOR]