Advancing Hospice and Palliative Care Social Work Leadership in Interprofessional Education and Practice

The importance of interprofessional collaboration in achieving high quality outcomes, improving patient quality of life, and decreasing costs has been growing significantly in health care. Palliative care has been viewed as an exemplary model of interprofessional care delivery, yet best practices in both interprofessional education (IPE) and interprofessional practice (IPP) in the field are still developing. So, too, is the leadership of hospice and palliative care social workers within IPE and IPP. Generating evidence regarding best practices that can prepare social work professionals for collaborative practice is essential. Lessons learned from practice experiences of social workers working in hospice and palliative care can inform educational efforts of all professionals. The emergence of interprofessional education and competencies is a development that is relevant to social work practice in this field. Opportunities for hospice and palliative social workers to demonstrate leadership in IPE and IPP are presented in this article.     

The Attitudes of Social Work Students Toward End-of-Life Care Planning

This study examined the attitudes of social work students toward end-of-life care planning, as well as their degree of willingness to engage in this area of social work practice. Factors associated with their attitudes were measured through structured surveys completed by 102 social work students (N = 102) at a school of social work in the southeast. Results indicated that these social work students tended to have positive attitudes toward end-of-life care planning in general. Moreover, these attitudes were positively associated with preference for pain relief treatment, higher levels of comfort when discussing death, more emphasis on self-determination, and apprehension of conflicts of self-determination. The results of this study underscored the increased societal need for recognition of personal preferences in end-of-life care, higher levels of comfort when discussing death, and an increased commitment of social workers' to maintaining the ethical principle of the client's right to self-determination in end-of-life planning. While this is not surprising, it points to a continuing need to re-assess where the field stands in its preparation of social work professionals who will work closely with people who are dying and their families.     

Enhancing Palliative Care for Low-Income Elders with Chronic Disease: Feasibility of a Hospice Consultation Model

Challenges exist in assimilating palliative care within community-based services for nursing home eligible low-income elders with complex chronic illness as they approach the end of life (EOL). This study assessed the feasibility of a consultation model, with hospice clinicians working with three Care Wisconsin Partnership Program teams. Consults occurred primarily during team meetings and also informally and on joint patient visits and were primarily with the palliative care nurse addressing physical issues. Fifty-seven percent of consultant recommendations were implemented. Benefits of consultation were identified with focus groups of clinical staff as were opportunities and barriers to the implementation. Models of integration are proposed.     

Attitudes Toward Women in Health Care Organizations: A Turkish Case Study

Abstract

The aim of this article is to examine the health care employees’ attitudes toward women in health care organizations in Turkey. It was measured using a 25-item scale by Spence, Helmreich, and Stapp (1973 Spence, J. T., Helmreich, R., & Stapp, J. (1973). A short version of the Attitudes toward Women Scale (AWS). Bulletin of the Psychonomic Society, 2(4), 219–220. doi:10.3758/BF03329252[Crossref] , [Google Scholar]). The study was conducted on 541 employees: 279 males and 262 females. Structural equation model (SEM) was applied to analyze the relationship between gender, marital status, and income and attitudes toward woman. The result of this analysis showed that the relations between gender, marital status, and income and attitudes toward woman were statistically significant. All three hypotheses were statistically supported. This result indicated that employees’ marital status and (monthly) income significantly predicted their scores of attitudes toward woman in a positive direction. Besides, employees’ gender significantly predicted their scores of attitudes toward woman in an inverse direction. Future research can focus on investigating the effects of the attitudes toward women on other elements (e.g., performance, motivation, job satisfaction) or a wider sample to reach more generalized results.     

Burnout and Death Anxiety in Hospice Social Workers

Hospice work has been regarded as particularly stressful due to the complexity inherent in the provision of end-of-life care. Burnout and death anxiety are especially relevant to hospice social workers because they regularly function in a high-stress, high-loss environment. The purpose of this study was threefold: to determine the prevalence of burnout and death anxiety among hospice social workers; to examine associations between burnout and death anxiety; and to explore the factors which may contribute to the development of death anxiety and burnout. Participants completed four items: the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), the Death Anxiety Questionnaire (DAQ), a demographic questionnaire, and a set of open-ended questions. Findings indicate that mean scores on the subscales of the MBI-HSS ranged from the low to moderate range and that a strong positive correlation existed between death anxiety and the depersonalization subscale of the MBI. Three key themes emerged from the qualitative data: (a) personal interest in hospice social work developed through a variety of ways; (b) although death anxiety decreased from exposure and understanding of the death process, there was increased death anxiety surrounding working with certain patients; and (c) burnout was primarily related to workload or difficult cases.     

Pediatric Palliative and End-of-Life Care

Abstract

Pediatric oncology social workers are often engaged in the psychosocial care of dying children and their families. Despite their participation on the interdisciplinary team, the role for social work in pe-diatric palliative and end-of-life care has not been clearly defined. This survey of 131 pediatric oncology social workers identified current and best social work practices for care of children and their families at the end of life. Implications for practice, education, and research are discussed.     

Social Workers' Personal Death Attitudes,Experiences, and Advance Directive Communication Behavior

Abstract

This research surveyed 29 social workers to examine their personal death attitudes and experiences in relation to their advance directives communication practice behavior. The study measured death attitudes on 5 dimensions: fear, avoidance, neutral, approach, or escape acceptance of death. Participants' personal experiences with terminal illness and death were also assessed. Advance directive communication practices were operationalized as 7 phases: initiation of the topic, disclosure of information, identification of a surrogate decision-maker, discussion of treatment options, elicitation of patient values, interaction with family members, and collaboration with other health care professionals. Findings suggest that social workers' advance directive communication behavior differs by practitioners' death attitudes and experiences. Implications for social work education and professional development are discussed.     

Attitudes Toward the Poor and Attributions for Poverty

Prior psychological research on attitudes toward the poor has focused almost exclusively on the attributions people make to explain why individuals are poor (e.g., Smith & Stone, 1989; Zucker & Weiner, 1993). The goal of the current study was to investigate the relationships among feelings about the poor and poverty, stereotypes of the poor, attributions for poverty, and sociopolitical ideologies (as assessed by the Protestant Ethic, Belief in a Just World, and Right Wing Authoritarianism Scales). In our Midwestern college sample (n = 209), attitudes toward the poor were found to be significantly more negative than attitudes toward the middle class. In addition, participants were most likely to blame poor people them-selves for their poverty. However, attitudes toward the poor and attributions for the causes of poverty were found to vary among individuals from different sociodemographic backgrounds and by degree of endorsement of Protestant ethic, just world, and authoritarianism beliefs. Few gender differences were obtained.