Evaluation of social work practice in health care settings

The purpose of this article is to encourage social workers in health care settings to evaluate the effectiveness of their practice. Recent studies of intervention outcome in health care settings are reviewed on four dimensions. Because most of these utilize large group designs and social workers in direct practice rarely conduct this type of research, single-system designs are proposed as a complementary and feasible approach to evaluation. Issues in the use of single-system designs within health care settings and a case example will be discussed.     

Emotional dissonance in medical social work practice

This qualitative study examined several ecological aspects of medical social work practice that affect social workers' emotional well-being. Forty-seven medical social workers from seven hospitals participated in small group interviews in which practice experiences were explored. A grounded theory approach was used to analyze the data, with emotional dissonance emerging as a central theme. Community, family, and individual factors contributing to emotional dissonance are presented, and the effect of social support is examined.     

Issues for hospitals in educating social work students for social work practice in health care settings

Conflicting values and issues emerge when hospital and professional school converge to educate the next generation of the profession. These values derive from issues of authority, responsibility, accountability, status, communication, and mutuality. This paper identifies their occurrence, describes a method for managing them, and delineates a hospital social work department's role in developing an educationally based, practice focused practicum site. The components and results of the relationship between the department and the school, including details of the practicum model, are discussed.     

Culturally sensitive social work practice with Arab clients in mental health settings

Several culturally specific practical considerations should inform social work interventions with ethnic Arab peoples in Arab countries or in Western nations. These include taking into account gender relations, individuals' places in their families and communities, patterns of mental health services use, and, for practice in Western nations, the client's level of acculturation. Such aspects provide the basis for specific guidelines in working with ethnic Arab mental health clients. These include an emphasis on short-term, directive treatment; communication patterns that are passive and informal; patients' understanding of external loci of control and their use of ethnospecific idioms of distress; and, where appropriate, the integration of modern and traditional healing systems.     

Understanding the critical role of social work in safety net medical settings: framework for research and practice in the emergency department

Social workers in Emergency Departments (ED) provide counseling, community resource linkage, and discharge planning. The ED is a critical intervention point for patients with multiple unmet medical, psychological, and social needs, and little or no other contact with service providers. In part because of its role as a medical safety net for underserved populations, use of the ED has steadily increased over time. There is limited research examining the utility of social services in the ED. This article provides a brief history of hospital social work and a literature review of ED social work research with the goal of advancing current research and practice agendas.     

Transforming general practice: the redistribution of medical work in primary care

The paper focuses on the redistribution of medical work within primary health care teams. It reports the results of the analysis of interviews with general practitioners, practice nurses and managers, undertaken as part of an ethnographic study of primary care organisation and practice during a period of rapid organisational change. By examining the ways in which the respondents account for how work is being redefined and redistributed, we explore how current government policy and professional discourses combine to reconfigure both the identities of those who work in primary care and the nature of patienthood. In particular, we show how general practitioners are being reconfigured as medical specialists or consultants in ways that seem to depart radically from earlier claims that general practice is a distinctive field of social or biographical medicine. Within this new discourse medical work is distributed between doctors, nurses and unqualified staff in ways which make explicit the reduction of general practice work to sets of biomedical problems or tasks. At the same time, the devolution of much general practice work to less qualified and cheaper personnel is justified by drawing on a discourse of person-centred medicine.     

Cultural differences in health beliefs: implications for social work practice in health care settings.

Individuals of diverse ethnic backgrounds often have beliefs about health, disease and treatment which vary significantly from American scientific medical practice. Cultural and subcultural health beliefs also vary among blacks, Hispanics and Asians. Individual differences within cultural groups may be influenced by length of time in the United States, age and social economic status. Social work activities which can improve health care services to ethnic minorities are identified.     

Predicting patterns of social work staffing in hospital settings

One long-standing problem of social work departments in acute care hospitals has been their diverse patterns of staffing. The lack of a standard or guide has tended to diminish the utilization of social work services in hospital settings. Over a period of six years, the Society for Hospital Social Work Directors of the American Hospital Association developed and revised a guide for inpatient staffing. The guide is designed to assist hospital and social work administrators establish an inpatient line staffing plan which is based on the number of hospital beds, the number of patients to be served and the number of functions carried. The logic of the inquiry and the findings can serve as a base for future research in inpatient, ambulatory care and other settings which serve special populations.     

Hospital social work practice in Zimbabwe

This article examines hospital work practice in Zimbabwe based on a literature review. It argues that the country is emerging from a ten year economic and political crisis which has affected the lives of the majority of the population. The health and education sectors have been the hardest hit since teachers, doctors, nurses as well as social workers have left the country in large numbers. The article highlights the various roles played by social workers in hospitals in Zimbabwe and the challenges they face in their day to day work. Solutions to these challenges are also suggested.     

Psychosocial issues within primary health care settings: challenges and opportunities for social work practice

Given the important role of primary health care and the impact of psychosocial issues on health care, the records of individuals referred to social workers in two urban health care clinics serving low-income individuals were analyzed. Major psychosocial issues included family problems, depression, anxiety, substance abuse, sexual abuse, and violence. Women were more likely to have suffered violence while many of the men had problems dealing with their own aggression toward others. Women with depressive symptoms were more likely than other women to report substance abuse, financial problems, sexual abuse, anxiety, and physical problems. Implications for training and practice are discussed.