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Oversubscribed social work (SW) courses and a workforce review in Northern Ireland prompted a review of admissions, to ensure recruitment of applicants with strong core values. Concerns regarding authorship, plagiarism and reliability of personal statements, and calls for values-based recruitment underpinned this research. This study evaluates psychometric properties of an SW specific personal statement (PS) and a values-based psychological screening tool, Social Work Match (SWM). Social Work students (n = 112), who commenced the 3-year undergraduate route (UGR) or the 2-year relevant graduate route (RGR) were invited to participate. Their PS scores and SWM scores permitted investigation of scoring outcomes and psychometric properties. Statistical analysis was conducted using Minitab 17. Forty-nine participants (5 male, 44 female) completed SWM on two occasions (October 2020 and January 2021). Findings provide practical, theoretical, statistical, and qualitative reasons for concluding that the PS has substantial limitations as a measure of suitability. It does not compare well with international test standards for psychometric tests. In contrast, SWM is a valid and reliable measure with good discriminatory power, standardized administration and consistent marking. SWM is a viable alternative to the PS for assessing suitability/shortlisting applicants for social work interviews.

Professional placements are integral to social work education and provide formative but variable learning opportunities for students. As social work programs expand and requirements for placements increase, non-traditional settings are increasingly utilized, risking further variability of student experience. This paper reports on qualitative responses to two open-ended questions in a cross sectional survey conducted with social work students from four universities on the island of Ireland. Questions included (1) what students found most helpful in assisting their learning, and (2) what would have improved their learning during placement. Braun and Clarke’s six-step approach to thematic analysis was used to analyse qualitative data from 427 responses to question one, and 355 responses to question two. Four key pillars of practice learning were identified: enabling relationship(s); ‘real world’ practice; structured teaching and learning; and academic-practice alignment. Drawing on these findings the paper presents a framework for integrated learning which promotes students’ capacity for active inquiry in practice. Linked processes of relational knowing and structured teaching and learning emerged as integral to knowledge acquisition and professional development on placement. Findings re-established the significance of the supervisory relationship and relationship-based learning.

Background: The SARS-Cov-2 (COVID-19) pandemic affected the delivery of health and social care services globally. However, little is known about how palliative care social work services were impacted. Aim: The aim of this study was to capture and analyse data from palliative care social workers who provided professional support in a range of settings across 21 countries during the COVID-19 pandemic. Design: A cross-sectional survey-based design was used for this empirical study and this paper primarily focuses on the quantitative responses. Setting/participants: Participants, palliative care social workers, were drawn internationally via members of the EAPC Social Work Task Force and the World Hospice Palliative Care Social Work network. Results: We received 362 survey responses from 21 countries. Most (79%) respondents worked with adults in in-patient units or hospitals. The number of referrals during COVID-19 increased more in non-European countries, compared to European countries. The full range of social work services could no longer be delivered, existing services changed and 65.3% of participants reported higher levels of pressure during the pandemic, which was linked to higher levels of staff absence and additional duties. For many respondents (40.8%), this included facilitating online communication between patients and their families. Conclusions: Our findings indicate that restrictions to limit the spread of COVID-19 resulted in adaptations to service delivery, increased pressure on staff and moral distress, like other health and social care professions. All members of the palliative team need support and supervision to ensure effective interdisciplinary working and team cohesion.

The SARS-CoV-2 coronavirus-19 (COVID-19) generated life-defining challenges on a global level, affecting healthcare professionals, who faced the same imminent public health threat as patients and families. Reduced face-to-face contact, wearing personal protective equipment and enforcing visitor restrictions generated moral distress in healthcare professionals, unable to provide holistic care. This scoping review explored the impact of the COVID-19 pandemic on palliative care social workers (PCSWs). PubMED, CINAHL and PsycINFO were systematically searched. Empirical studies and reflective articles about palliative care social work during the pandemic were screened. Data extraction used Arksey and O’Malley’s framework. Thematic analysis was underpinned by Braun and Clarke for identifying, analysing and reporting patterns. From 706 citations retrieved, 125 were selected for full-text review and 32 were included in the scoping review. Thematic analysis revealed three themes: (i) moral distress, (ii) transitioning and (iii) inequality. Implementing visitor restrictions caused moral distress and raised questions about their justification. Not being present at the time of death generated feelings of anger among bereaved family members. Virtual communication replaced face-to-face contact, yet improved access to Telehealth. Inequalities were illuminated and PCSWs advocated for disadvantaged populations, worked creatively to minimise suffering or stigma and supported peers.

The COVID-19 pandemic has affected all aspects of people’s lives worldwide, including the work of social workers and the education of social work students. Field placements are a significant part of social work education, but during the pandemic they were cut short and most teachings moved online. The current mixed methods study examined the effects of social work education on social work students’ empathy and resilience during the COVID-19 pandemic on the island of Ireland. A matched sample of forty-nine students completed an online survey at the start (T1) of their degree and at the end (T2). A further 229 students who only completed the T1 survey were compared to 70 others who only completed the T2 survey. The results showed improved resilience in the cohort comparison. There were no differences in empathy in the matched sample nor between the cohorts. Thematic analysis of students’ narratives showed that they found the switch to online learning difficult, with some reporting negative impacts on their mental health and the abrupt ending of placements impacting their feelings of preparedness for practice. Implications of this study and future research areas are discussed.

Social Work qualifying programmes teach students the necessary knowledge, skills and values during a series of taught modules. Formal opportunities to integrate knowledge into practice are provided through practice placements in social work agencies. Each practice placement enables agency and/or academic staff to gate-keep entry into the profession, through assessing student competence against agreed practice learning requirements, readiness to practice, and adherence to professional social work standards. This research study seeks to expand our understanding of the incidence of and reasons why students failed their practice placement whilst studying social work on the island of Ireland. On receipt of ethical approval, Practice Teacher reports and minutes of Practice Assessment Panels were used for data collection. Sixty-three students (19 male, 44 female; mean age 34 years) failed placement 2015-2019, with the majority (58.7%) failing first placement. Reasons for failing were categorised into knowledge, skills, values and personal reasons. The most common reasons for failing were a poor understanding of the professional social work role, poor time management, poor written work, the inability to follow direction, limited application of knowledge to practice, and poor professional conduct. Results suggest most students disclosed mitigating circumstances, which affected engagement and competence.

During their social work education, students engage in a number of stressful learning activities, often simultaneously, which can negatively impact their well-being, mental health and social work practice. Mindfulness practices are beginning to be integrated into social work curricula globally to enhance student self-care along with key social work practice skills and values. This mixed methods study examined the effects of a bespoke six-week online mindfulness-based social work and self-care (MBSWSC) programme on the stress, burnout, well-being, anxiety and depression levels of thirty social work students from two universities in the UK. This study also examined the effects of MBSWSC on a number of mindfulness-based mediators of change in these outcomes. Participant perceptions of the benefits of the MBSWSC programme on their well-being and social work practice are further explored via a thematic analysis of an open-ended questionnaire. Statistically significant changes in all variables were found post-programme except for depression and loss of empathy/depersonalisation, a facet of burnout. The qualitative data provided a deeper insight into the potential benefits of the programme for the enhancement of student well-being, mental health and anti-oppressive social work practice (AOP).

Social work is a demanding profession requiring a range of skills, competencies, and knowledge. Students are expected to learn about these practice related issues through immersion in real world experiences during their practice placement. A cross-sectional, retrospective survey was used to explore Finnish social work students’ (N = 95) experiences of learning activities employed by their supervisors during the practice placement, and the usefulness of these activities for developing professional competence and a sense of social work identity. Findings confirmed that students received a wide range of learning opportunities during their placement, but that there was considerable variation in the regularity of learning activities. The most useful learning activities included a collaborative working relationships and activities involving the student and their practice teacher, such as feedback, reflecting on work, feelings and values, observing others, and being assisted to learn new skills. In contrast, providing theoretical perspectives and linking theory to practice were regarded as least useful. Students with a lower overall learning activity score, were less likely to develop an understanding of social work identity during their placement. These results contribute to a growing evidence base, which can inform social work academics and practice teachers about learning activities that need to be offered to promote practice competence and professional identity of students, in preparation for professionally qualifying. publishedVersion

Understanding the characteristics, motivations, and experiences of student social workers is important to inform their professional education and support needs. To date, there has been relatively little research about social work students in Ireland, both North and South. This study reports on an all-Ireland survey of students beginning their social work course in Autumn 2018 in the six Universities delivering social work education. It describes the characteristics of the student cohort, examines the motivations behind choosing this career, and highlights some of the potentially relevant life experiences and beliefs which may have contributed to their ambition to join the social work profession. Implications for social work education, recommendations for curriculum development, workforce planning, and the provision of appropriate support for students are discussed.

Students have identified practice placements (or practice learning) as the single most important factor of social work education, but it is usually where issues of professional suitability become apparent. Whilst most students successfully complete their placements, a number experience difficulty and a minority ultimately fail. Protecting the profession from students not deemed suitable for professional practice requires a rigorous gatekeeping function and fair standards. On receipt of written consent, we interviewed eleven social work students who failed placement, and accessed progress reports written by Practice Teachers/Practice Educators. Participants included nine females, mean age of 33 years, seven failed their final placement and eight had registered with university disability services. Professionally transcribed interviews were analysed using an adapted version of Braun and Clarke’s method. Identified themes included the impact of personal issues; importance of working relationships; use and misuse of power; assessment and decision-making processes and developing insight and useful feedback. Students valued the opportunity to reflect on their experience and provided clear recommendations for improving how Practice Teachers, on-site supervisors, Tutors and peers can provide a supportive learning experience for students who require additional support during placement, and how to communicate concerns regarding competence more effectively.

BackgroundThe COVID-19 pandemic is a mass bereavement event which has profoundly disrupted grief experiences. Understanding support needs and access to support among people bereaved at this time is crucial to ensuring appropriate bereavement support infrastructure.AimTo investigate grief experiences, support needs and use of formal and informal bereavement support among people bereaved during the pandemic.DesignBaseline results from a longitudinal survey. Support needs and experiences of accessing support are reported using descriptive statistics and thematic analysis of free-text data.Setting/Participants711 adults bereaved in the UK between March-December 2020, recruited via media, social media, national associations and community/charitable organisations.ResultsHigh-level needs for emotional support were identified. Most participants had not sought support from bereavement services (59%, n=422) or their GP (60%, n=428). Of participants who had sought such support, over half experienced difficulties accessing bereavement services (56%, n=149)/GP support (52%, n=135). 51% reported high/severe vulnerability in grief; among these, 74% were not accessing bereavement or mental-health services. Barriers included limited availability, lack of appropriate support, discomfort asking for help, and not knowing how to access services. 39% (n=279) experienced difficulties getting support from family/friends, including relational challenges, little face-to-face contact, and disrupted collective mourning. The perceived uniqueness of pandemic bereavement and wider societal strains exacerbated their isolation.ConclusionsPeople bereaved during the pandemic have high levels of support needs alongside difficulties accessing support. We recommend increased provision and tailoring of bereavement services, improved information on support options, and social/educational initiatives to bolster informal support and ameliorate isolation.Key statementsWhat is already known about the topic?– Features of pandemic bereavement, such as traumatic death experiences, exacerbate family distress and add to the complexity of grief.– In pre-pandemic times most people mainly relied on the informal support of friends and family to cope with their bereavement, but an estimated 40% required more formal therapeutic support from bereavement or mental health services.– Bereaved people experience difficulties getting the support that they need from bereavement services and their social networks.What this paper adds– Participants had high level needs for emotional support, especially dealing with/expressing feelings, with 51% experiencing high or severe vulnerability in grief; however, 74% of this group were not accessing formal bereavement service or mental health support.– Most participants had not tried to access bereavement services, for reasons such as lack of appropriate support, discomfort in asking for help and uncertainty of how to access services; of the 41% who tried, 56% experienced difficulties such as long waiting lists or ineligibility.– A substantial proportion of people (39%) reported difficulties accessing support from friends and family; reduced in-person contact affected the perceived quality of support and disrupted collective mourning practices, whilst the wider social difficulties of the pandemic compounded feelings of isolation.Implications for policy and practice– Further investment in the provision of tailored bereavement support is needed to meet the diverse needs and backgrounds of bereaved people, including support that is culturally and crisis/context competent, and group-based support for those with shared experiences and characteristics.– To raise awareness of support options, information on grief and bereavement services should be provided proactively following a death and made available in online and community settings, with GPs and other primary care providers better resourced to signpost to appropriate support.– Following compassionate communities approaches, expanded provision of informal community-based support and activities could help with isolation, whilst longer-term educational and societal initiatives are needed to bolster community support for people experiencing death, dying and bereavement.

In the context of widespread loss, isolation, and grief due to COVID-19, palliative social workers came together in the fall of 2020 to form an international group named the World Hospice and Palliative Care Social Work Network (WHPCSW). This emerging global network is committed to amplifying the innovative work, nuanced skills, research, and education and training provided by palliative social workers across different settings around the world. This article highlights some of the novel interventions developed by social workers in response to the pandemic and describes this coalescing WHPCSW network along with information about its mission and membership.

Background COVID-19 represents a mass bereavement event, with 80,000+ excess UK deaths. The unprecedented clinical and social restrictions are potential risk factors for poor bereavement outcomes. This study investigates the bereavement experiences, support needs and support use of people bereaved during the pandemic.Methods Interim findings from the first round of a mixed methods longitudinal survey of people bereaved in the UK since 16March 2020. The survey was disseminated via media, social media, national associations and community/charitable organisations. Grief was assessed using the Adult Attitude to Grief Scale.Results 532 bereaved people participated (91% female). Place of death: hospital (55%), home (22%), care home (15%), hospice (5%); 46% of deaths were confirmed/suspected COVID-19. Experiences of end of life care varied: 23% were ‘never’ involved in decisions about their loved one’s care, 36% felt ‘not at all’ supported by healthcare professionals after the death, 51% were not provided with information about bereavement support. Respondents reported high levels of problems specific to the pandemic bereavement context (e.g. 56% unable to visit prior to death, 67% social isolation and loneliness). Over half of participants demonstrated ‘severe’ (28%) or ‘high’ (24%) levels of vulnerability in grief, and support needs were high/fairly high in six psycho-emotional domains (51% to 62%). COVID-19 deaths were associated with higher levels of bereavement problems (p

The doctor saw a tremor in dad’s right hand, which we did not fully understand.For many years, dad managed the progression of Parkinson’s pretty well, with gradual disruption to his life, as far as...

Background:Prison populations are growing globally with an increase in older and infirm prisoners, as well as longer prison sentences, meaning more prisoners are likely to die while incarcerated. This scoping review explored the experiences of a death in prison custody on staff and relatives.Methods:Ovid MEDLINE, Embase, CINAHL and PsycINFO were professionally searched, followed by a hand search. Empirical and non-empirical studies of deaths in prison custody were screened. Data extraction used Arksey and O’Malley’s framework. Thematic analysis was underpinned by Braun and Clarke for identifying, analysing and reporting patterns. Results:From 12,127 citations retrieved, 174 were selected for full-text review, and 22 were included in the final scoping review. Thematic analysis revealed four themes: (i) transformative effect (ii) time delays, (iii) conflicts of interest, and (iv) support. Prison staff avoided contaminating their personal lives. Families were distressed by inaccurate and untimely information, inappropriate constraints and poor communication. Staff balanced security and humanitarian needs. Bereaved relatives and staff felt isolated, alienated and unsupported. Conclusions and recommendations:Unmet advocacy, communication and social care needs, poor end-of-life and bereavement care could be improved through staff training and social work intervention. Staff need psychosocial support, supervision and counselling.

Lung cancer is common in males as well as females and is one of the most common causes of cancer related deaths worldwide. To gain an in-depth understanding of the ‘pedagogy of suffering’ (Frank, 1995: 145), the lived experiences of 12 adult patients in Northern Ireland diagnosed with advanced lung cancer were captured during two qualitative interviews with each patient (one month apart), which were audio-recorded. This article outlines analysis which used Frank’s (1995) narrative structures of restitution, chaos and quest, to provide rich insights into how patients narrated their ‘suffering’ over time. Findings revealed frustration and loss of faith in medical physicians due to a delayed diagnosis; resignation regarding treatment options and outcomes; externalisation of a disease that society fears, curbs life expectancy and causes biographical disruption; and powerlessness underpinned by a heroic return to put affairs in order, encourage others and share hopes for the future. In an era of health and social work practitioners experiencing increasing bureaucracy and caseloads, these findings highlight the importance of prioritising the psychosocial needs of patients, supporting patients with the emotional and practical challenges of living with a life-limiting illness, and of skilful practitioners promoting peaceful closure in end of life care.

Background: Enabling patients to die in their preferred place is important but achieving preferred place of death may increase the informal carer’s risk into bereavement. Aim: To determine risk factors of family carers bereaved through cancer in Northern Ireland. Design: These results form part of a larger QUALYCARE-NI study which used postal questionnaires to capture quantitative data on carer’s bereavement scores using the Texas Revised Inventory of Grief. Setting/participants: Participants were individuals who registered the death of a person between 1 December 2011 and 31 May 2012; where cancer (defined by ICD10 codes C00-D48) was the primary cause; where the deceased was over 18 years of age and death occurred at home, hospice, nursing home or hospital in Northern Ireland. Participants were approached in confidence by the Demography and Methodology Branch of the Northern Ireland Statistics and Research Agency. Those wishing to decline participation were invited to return the reply slip. Non-responders received a second questionnaire 6 weeks after initial invitation. Results indicated that risk factors positively influencing bereavement outcomes included patients having no preference for place of death and carers remaining in employment pre- or post-bereavement. In contrast, patients dying in hospital, carers stopping work, being of lower socio-economic status and close kinship to the deceased negatively affected bereavement scores. Family carers should be adequately supported to continue in employment; priority should be given to assessing the financial needs of families from lower socio-economic areas; and bereavement support should focus on close relatives of the deceased.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effectiveness of CBT (e.g. cognitive therapy, cognitive behavioural therapy, rational emotive behaviour therapy, prolonged grief CBT) compared with non-CBT therapies (e.g. psychodynamic, humanistic, family or systemic therapies) for treating people with bereavement-related MDD or PGD. To assess the effectiveness of CBT compared with usual care or waiting list for treating people with bereavement-related MDD or PGD. To assess the effectiveness of CBT compared with pharmacological interventions (e.g. antidepressant medications and other drug therapies used explicitly for treating depressive disorders (Sadock 2009)) for treating people with bereavement-related MDD or PGD.Copyright © 2018 The Cochrane Collaboration.

Practice learning is integral to the curriculum for qualifying social work students. Accreditation standards require regular student supervision and exposure to specific learning activities. Most agencies offer high-quality placements, but organizational cutbacks may affect supervision and restrict the development of competence and professional identity. Undergraduate social work students in Northern Ireland universities (n=396) were surveyed about the usefulness of the learning activities they received on placement for developing practice competence and professional social work identity. Results suggest that students most valued regular supervision, constructive feedback, observing social workers, and thinking critically about the social work role. Differences were reported across placements with students feeling disadvantaged in agencies where there was no clear social work role.

Mindfulness is becoming more popular as emerging research demonstrates its benefits for self-care, by cultivating calmness and decreasing stress or anxiety. This pilot study aimed to measure the impact of a six-week Mindfulness course, modelled on the manualised treatment program developed by Kabat-Zinn, on the mental well-being, stress and resilience of undergraduate social work students in Northern Ireland. This was a mixed methods study involving two groups: (1) intervention group participants who attended a six week Mindfulness course (April – May 2016) and (2) control group participants. Basic socio-demographic data were collected from all participants and all were invited to complete the Warwick-Edinburgh Mental Well-being scale, the Perceived Stress Scale and the Resilience Scale during weeks 1 and 6. Statistical tests were used to compare mean scores from the scales, and qualitative data were manually analysed using thematic content analysis.Findings indicated significant changes in the scores for well-being, stress and resilience for the intervention group, but not for the control group. Mindfulness may not appeal to all students so should not be a mandatory component of training, but may be offered as one of the wider approaches to self-care for undergraduate social work degree students.

Objective:Provision of bereavement support is an essential component of palliative care service delivery. While bereavement support is integral to palliative care, it is typically insufficiently resourced, under-researched, and not systematically applied. Our aim was to develop bereavement standards to assist palliative care services to provide targeted support to family caregivers.Method:We employed a multiple-methods design for our study, which included: (1) a literature review, (2) a survey of palliative care service providers in Australia, (3) interviews with national (Australian) and international experts, (4) key stakeholder workshops, and (5) a modified Delphi-type survey.Results:A total of 10 standards were developed along with a pragmatic care pathway to assist palliative care services with implementation of the standards.Significance of results:The bereavement standards and care pathway constitute a key initiative in the evolution of bereavement support provided by palliative care services. Future endeavors should refine and examine the impact of these standards. Additional research is required to enhance systematic approaches to quality bereavement care.

Background: Research suggests that the public appear to be confused about the meaning of palliative care. Given the ageing population and associated increase in the number of patients requiring palliative care, it is vital to explore the public’s understanding of this concept. Health-promoting palliative care seeks to translate hospice and palliative care ideals into broader public health practice. Aim: To explore public perceptions of palliative care and identify strategies to raise awareness. Design: An exploratory qualitative approach. Participants: Semi-structured telephone interviews were undertaken ( N = 50) with members of the public who volunteered to participate in the study. The interviews focused on knowledge and perceptions of palliative care, expectations of palliative care services and the identification of strategies to raise public awareness of palliative care. The interviews were audio recorded and content analysed. Results: Most participants had a general knowledge of palliative care, largely influenced by their own personal experience. They identified that palliative care was about caring for people who were dying and maintaining comfort in the last days of life. Participant’s expectations of services included the following: holistic support, symptom management, good communication and practical support to enable choice and carer support. Key aspects identified for promoting palliative care were the development of understanding and use of the term itself and targeted educational strategies. Conclusion: Experience of palliative care generates understanding in the general public who also have ideas for increasing knowledge and awareness. The findings can inform policymakers about strategies to raise public awareness of palliative care.

Practice learning accounts for half of the content of the bachelor of social work degree course requirements in Northern Ireland in their field education programmes and share a professional and ethical responsibility with practice teachers to provide appropriate learning environments to prepare students as competent and professional practitioners. The accreditation standards for practice learning require the placement to provide students with regular supervision and exposure to a range of learning strategies, but there is little research that actually identifies the types of placements offering this learning and the key activities provided. This paper builds on an Australian study and surveys social work students in two programmes in Northern Ireland about their exposure to a range of learning activities, how frequently they were provided and how it compares to what is required by the Northern Ireland practice standards. The results indicated that, although most students were satisfied with the supervision and support they received during their placement, the frequency of supervision and type of learning activities varied according to different settings, year levels and who provided the learning opportunities.

Aim: To explore how older people with lung and colorectal cancer view registered complementary therapy (CT) services in Northern Ireland. Background: A literature review highlighted gaps around information, access, and communication between patients and health professionals regarding CT services. Methods: Using structured interviews, a survey of 68 patients in one hospital and one hospice was conducted in Belfast, Northern Ireland. Results: All respondents felt that CT services should be better promoted and more easily accessible to older people with cancer. Some patients were concerned about the lack of written information provided regarding CT services, which they believed led to poorer uptake and uncertainty regarding the potential benefits. Others were concerned that engaging in or disclosing CT usage might negatively affect existing relationships with medical professionals. Conclusion: Patients should be offered high quality written information on CT services to enable choice, improve knowledge, and promote wider access. Increased physician education may facilitate provision of such information.

Background International research suggests that the general public appear to be confused about what palliative care is and who provides it.1 2 An understanding of public views is needed in order to target education and policy campaigns and to manage future needs, expectations and resourcing of care. Aim The aim of this study was to establish the current levels of awareness and perceptions of palliative care among the general public in Northern Ireland. Methods A mixed methods study comprising two phases was undertaken. A community-based cross-sectional survey with a population of 3,557 individuals aged over 17 years was performed. Information was collected using a structured questionnaire consisting of 17 items. Open questions were subject to content analysis; closed questions were subject to descriptive statistics with inferential testing as appropriate. This was followed by semi structured telephone interviews (n=50). Results Responses indicated limited knowledge about palliative care. Respondents who worked in healthcare themselves or who had a close relative or friend who had used a palliative care service were more aware of palliative care and the availability of different palliative care services. The main barriers to raising awareness were fear, lack of interaction with health services and perception of lack of resources. A key aspect identified for promoting palliative care was the development of understanding and use of the term itself and targeted educational strategies. Conclusions Public awareness of the concept of palliative care and of service availability remains insufficient. An increased awareness of palliative care is needed, in order to improve knowledge of and access to services when required, empower individuals, involve communities and ultimately to improve the delivery of palliative and end-of-life care. (274)

Introduction Lung cancer is an unforgiving illness with most patients being diagnosed in the advanced stages of disease. How much do we really know about the range of end-of-life care decisions that patients encounter? Aim(s) and method(s) To explore end-of-life care decision-making by patients diagnosed with advanced lung cancer known to a community palliative care team in Northern Ireland. Qualitative data were obtained during two individual interviews (mean duration 48 minutes) with 12 community patients diagnosed with advanced lung cancer. Llewellyn-Thomas9 decision-making framework informed data collection and data were analysed using Interpretative Phenomenological Analysis and narrative analysis. Results Emergent themes mirrored an illness journey. (1) Beginnings: There9s something not right, bad news, emotional responses and no way back; (2) Middles: Treatment decision-making, impact of treatment on quality of life and impact of illness on self, social relations and engagement with the physical world; (3) Endings: Preferred priorities for care, a good death, legacy, coping patterns and funeral wishes. Three cross-cutting themes were common: preciousness of time; importance of skilful communication, and maintenance of hope. Conclusion(s) This study offers insight into patients9 experiences of living with advanced lung cancer, their daily navigation of decisions that surpassed our assumptions, and patient expectations of professionals. Despite knowing their inevitable fate, findings highlighted the importance of maintaining hope and exploring futures.

Background: Many medical decisions are guided by principles of autonomy, non-maleficence, beneficence, and justice, yet involve uncertainty and ethical dilemmas. It is important to understand what illness, life and death mean to each patient, alongside their values, priorities, preferences, knowledge and expectations regarding treatment and care. Methods: Focus group meetings, conducted with 10 members of a Community Specialist Palliative Care Team in Northern Ireland, who cared for patients diagnosed with advanced lung cancer, were analysed using Interpretative Phenomenological Analysis. Results: Three super-ordinate themes were identified: time, decision-making and communication. Timely referrals for exploratory tests, accurate communication of test results and ‘red flag’ systems for treatment or services, maximising IT systems, were recommended. Uncertainty, busy clinics, lack of privacy and perceived awkwardness impeded effective communication between professionals and patients. Having a trusting relationship, timely access to accurate diagnostic and prognostic information, competent communication skills, and respect for patient wishes, enabled communication. Implications for practice: professionals must build effective, trusting relationships with patients, carers and other professionals. Choices and decisions need to be navigated sensitively and competently. End-of-life care wishes or priorities should be reviewed regularly and documented.

This chapter provides a historical overview of professional identity within the context of social work, what we mean by professional identity, how we measure it and how we teach it to students. Through exploring definitions of professional social work identity and findings from empirical research involving social workers and students, we identify challenges for educators, based on competing social work discourses and multiple identities of practitioner, researcher and educator. Findings from empirical research, conducted by the author in Northern Ireland, highlight the learning activities that student social workers found most useful in terms of developing readiness for practice competence and professional social work identity (Cleak et al., 2016; Roulston et al., 2018). This research offers insights into the differing perspectives of students based on the placement setting and stage of training, as well as the perceived usefulness of specific learning activities. This chapter concludes with some evidence-informed advice to curriculum developers.

A pre-requisite to all social work with children is an understanding of their physical, emotional and educational needs. In the area of child protection work there is always the dilemma of ensuring that these key needs are adequately met.

Background: The World Health Organisation recognises palliative care as a global public health issue and this is reflected at strategic level. Despite this, palliative care may not be universally welcomed. Surveys over the last decade have suggested that the general public have a lack of knowledge and negative perceptions towards palliative care. A detailed and comprehensive understanding of public views is needed in order to target education and policy campaigns and to manage future needs, expectations and resourcing of end of life care. The aim of this study was to establish the current levels of awareness and attitudes towards palliative care among the general public in Northern Ireland. Methods: A community-based cross-sectional survey with a population of 3,557 individuals aged over 17 years was performed. Information was collected using a structured questionnaire consisting of 17 items. Open questions were subject to content analysis; closed questions were subject to descriptive statistics with inferential testing as appropriate.Results: A total of 600 responses were obtained (response rate 17%). Responses indicated limited knowledge about palliative care. Female gender and previous experience influenced awareness in a positive direction. Respondents who worked in healthcare themselves or who had a close relative or friend who had used a palliative care service were more aware of palliative care and the availability of different palliative care services. Findings reveal the preferred place of care was the family home. The main barriers to raising awareness were fear, lack of interaction with health services and perception of lack of resources. A number of strategies to enhance awareness, access and community involvement in palliative care were suggested.Conclusions: Public awareness of the concept of palliative care and of service availability remains insufficient for widespread effective and appropriate palliative care to be accepted as the norm. In particular, those withoutprevious family-related experiences lack awareness. This has implications for palliative care service provision and policy. An increased awareness of palliative care is needed, in order to improve knowledge of and access to services when required, empower individuals, involve communities and ultimately to realise the objectives contained within international strategies for palliative and end-of-life care.

Many patients with lung cancer are symptomatic from diagnosis, and quality of life (QoL) may be maximised through the use of specialist palliative care in parallel with other treatments. This study explored anxiety, depression, and QoL in five patients, predominantly male (n=4) and with mean age 74 years, using a ‘Breathing Space’ clinic over a 4-week period. Breathing Space is a nurse-led multidisciplinary outpatient clinic using integrative care with lung cancer patients. The patients received weekly interventions to improve their wellbeing. Qualitative data were collected to explore their expectations and experiences of the clinic, and quantitative data were captured using the Eastern Cooperative Oncology Group Performance Status Rating (ECOG-PSR), the Hospital Anxiety and Depression Scale (HADS), the EQ-VAS, and the EQ-5D. These data were analysed using thematic content analysis and SPSS respectively. It was found that preconceived ideas about clinic attendance were replaced with positive impressions. Anxiety and EQ-VAS scores improved for all patients, and depression scores improved for four of the five patients, although no tests of significance were made. The qualitative data indicated that there were psychosocial benefits to attending the clinic.