Models of Resilience: Developing Psychosocial Interventions for Parents of Children with Chronic Health Conditions

Research regarding family adaption and resilience in children with chronic health conditions has resulted in the development of a number of theoretical models and data‐driven psychosocial interventions in the field of pediatric psychology, some of which may not be well known in the field of family science. These models incorporate family systems theory and multiple resiliency factors within their framework to better describe the complex process of adaptation and subsequent adjustment outcomes. In this article, three contemporary resilience models within pediatric psychology are briefly reviewed and discussed. The development of a psychosocial intervention targeting uncertainty management for caregivers of children with cancer and the preliminary results are also presented as an exemplar of how such models may utilized to build interventions. Finally, the implications of the authors' findings and future research directions involving psychosocial interventions for families of children with chronic health conditions are discussed.     

Description of a Psychosocial Assessment Instrument and Risk Criteria to Support Social Work Recommendations for Kidney Transplant Candidates

Developing uniform criteria and a risk assessment clinical intervention plan to identify, assess, and assign psychosocial risk levels may help guide transplant social workers' interventions and justify their listing recommendation. This article describes a kidney pre-transplant psychosocial assessment instrument that is supported by psychosocial risk criteria and a risk assessment clinical intervention plan.     

Funding and planning for social care in later life: a deliberative focus group study

This study examined people's perceptions and behaviours in relation to planning for their social care needs, and their values and priorities concerning how social care should be funded. Eight deliberative focus groups were conducted in May 2018 with 53 participants, aged 25–82 years, in London, Manchester and rural locations near York and Sheffield. Multiple uncertainties created barriers to planning for social care needs including not knowing how much to save, not thinking it possible for an average person to save enough to meet significant needs, reluctance to plan for something potentially unnecessary, lack of suitable and secure ways of saving, and a perception of social care policy as unsettled. Participants also had significant concerns that they would not be able to obtain good‐quality care, regardless of resources. In addition, it was commonly thought unrealistic to expect families to provide more than low‐intensity, supplementary care, while use of housing assets to pay for care was considered unfair, both for home‐owners who could lose their assets and non‐home‐owners who were left reliant on the state although it was more acceptable where people were childless or had substantial assets. Participants thought any new arrangements should be inclusive, personally affordable, sustainable, transparent, good‐quality and honest. They preferred to contribute regularly rather than find considerable sums of money at times of crisis, and preferred to risk‐pool, with everyone obliged or heavily encouraged to contribute. Transparency was valued so those better at ‘working the system’ were not able to benefit unfairly  and participants wanted to know that, if they contributed, they would be assured of good‐quality care. Trust in Government and other institutions, however, was low. New funding arrangements should incorporate measures to increase transparency and trust, be clear about the responsibilities of individuals and the state, provide meaningful options to save, and place significant focus on improving actual and perceived care quality. For acceptability, proposals should be framed to emphasise their affective dimensions and positive values.     

The psychological and social impact of camp for children with chronic illnesses: a systematic review update

Advances in medicine have reduced mortality among children with complex medical conditions, resulting in a growing number of young patients living with chronic illnesses. Despite an improved prognosis, these children experience significant psychosocial morbidity, such as depression and anxiety. Therapeutic summer recreation camps have been proposed as an intervention to enhance quality of life among these children. The purpose of this systematic review was to assess the psychosocial impact of camp for children with chronic illnesses. A systematic review of central databases was undertaken using key words, and a rating tool – the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies – was employed to rate methodological quality. 21 studies were included in this systematic review. Although overall methodological quality was weak, camp participation appeared to offer short‐term psychosocial benefits on some parameters in children with a variety of chronic illnesses. There was some consistency in improved social outcomes, such as social interaction and acceptance. Based on the available evidence, it is premature to make robust claims regarding the psychosocial impact of camp as a therapeutic intervention. Theoretically informed camp programs, long‐term follow‐up, and incorporating camp‐based messaging into routine hospital care, may enhance the utility of camp as a potential psychosocial intervention in paediatrics.     

Psychosocial standards of care for children with cancer and their families: A national survey of pediatric oncology social workers

ABSTRACT

In 2015, an interdisciplinary group of psychosocial experts developed The Standards of Psychosocial Care for Children with Cancer and Their Families. This paper presents data from a national survey of pediatric oncology social workers and their experiences in delivering psychosocial care to children and families. In total, 107 social workers from 81 cancer institutions participated in a 25-item online survey that mirrored the 15 Standards for Psychosocial Care. Both closed and open-ended questions were included.

Social work participants reported that psychosocial support is being provided at most cancer centers surveyed, primarily by social workers and child life specialists, addressing adaptation to the cancer diagnosis, treatment, and transitions into survivorship or end-of-life care and bereavement. While social workers reported offering comprehensive services throughout the cancer trajectory, many of the 2015 Standards are not being systematically implemented. Areas for improvement include funding for psychosocial support staff and programs, incorporation of standardized assessment measures, assessment for financial burden throughout treatment and beyond, consistent access to psychology and psychiatry, integrated care for parents and siblings, and more inclusion of palliative care services from time of diagnosis.     

Secondary Prevention of Work Disability: Community-Based Psychosocial Intervention for Musculoskeletal Disorders

INTRODUCTION: One objective of the present research was to examine the degree to which psychological risk factors could be reduced through participation in a community-based psychosocial intervention for work-related musculoskeletal disorders. A second objective was to examine whether psychosocial risk reduction had an effect on the probability of return to work. METHODS: Participants were 215 Workers Compensation Board claimants with work-related musculoskeletal disorders who had been absent from work for an average of approximately 7 months (M = 28.8 weeks, range = 4-100 weeks) and were referred to a community-based multidisciplinary secondary prevention program in Nova Scotia, Canada. RESULTS: In the current sample, 63.7% of participants returned to work within 4 weeks of treatment termination. The percentage reductions in targeted risk factors from pretreatment to posttreatment were as follows: catastrophizing (32%), depression (26%), fear of movement/re-injury (11%), and perceived disability (26%). Logistic regression indicated that elevated pretreatment scores on fear of movement and re-injury (OR = 0.58, 95% CI = 0.35-0.95) and pain severity (OR = 0.64, 95% CI = 0.43-0.96) were associated with a lower probability of return to work. A second logistic regression addressing the relation between risk factor reduction and return to work revealed that only reductions in pain catastrophizing (OR = 0.17, 95% CI = 0.07-0.46) were significant predictors of return to work. CONCLUSIONS: The results of the present study provide further evidence that risk factor reduction can impact positively on short term return to work outcomes. SIGNIFICANCE: Outcomes of rehabilitation programs for work disability might be improved by incorporating interventions that specifically target catastrophic thinking. Community-based models of psychosocial intervention might represent a viable approach to the management of work disability associated with musculoskeletal disorders.     

Families affected by childhood cancer: an analysis of the provision of social support within online support groups

Background With increasing access to the Internet, there are new opportunities available to families to seek information, advice and support about childhood cancer online. Methods A total of 487 messages were retrieved from three childhood cancer online support groups and were analysed using deductive thematic analysis for the presence of support-intended communication using Cutrona and Suhr's social support typology. In addition, the messages were examined for negative experiences or disadvantages. Results The results revealed the presence of five types of social support: emotional, informational, esteem support and tangible assistance. In addition, some potential limitations of online support were identified, including a lack of responses and difficulties in maintaining relationships outside the online group context. Conclusion This study suggests that online support groups may offer the potential to support family members of children with cancer. In particular, it may be a useful resource for those seeking emotional and information support. However, there may be limitations associated with the use of online support groups.     

Health benefits of primary care social work for adults with complex health and social needs: a systematic review

The prevalence of complex health and social needs in primary care patients is growing. Furthermore, recent research suggests that the impact of psychosocial distress on the significantly poorer health outcomes in this population may have been underestimated. The potential of social work in primary care settings has been extensively discussed in both health and social work literature and there is evidence that social work interventions in other settings are particularly effective in addressing psychosocial needs. However, the evidence base for specific improved health outcomes related to primary care social work is minimal. This review aimed to identify and synthesise the available evidence on the health benefits of social work interventions in primary care settings. Nine electronic databases were searched from 1990 to 2015 and seven primary research studies were retrieved. Due to the heterogeneity of studies, a narrative synthesis was conducted. Although there is no definitive evidence for effectiveness, results suggest a promising role for primary care social work interventions in improving health outcomes. These include subjective health measures and self‐management of long‐term conditions, reducing psychosocial morbidity and barriers to treatment and health maintenance. Although few rigorous study designs were found, the contextual detail and clinical settings of studies provide evidence of the practice applicability of social work intervention. Emerging policy on the integration of health and social care may provide an opportunity to develop this model of care.