The Role of Empowerment in Home Care Work

ABSTRACT

The home care industry experiences similar problems with the recruitment and retention of direct care workers (DCWs) as those faced by institutions, and it is important to identify strategies to help retain and grow this important workforce. The empowerment of DCWs has been shown to be an effective strategy for increasing job satisfaction and decreasing turnover in nursing homes but has not been studied in home care. Using Kanter’s organizational theory of empowerment, including structural empowerment (structure of opportunity, access to resources, access to information, and access to support) and psychological empowerment (meaning, competence, self-determination or autonomy, and impact) this study examined whether home care workers (HCWs) feel empowered in carrying out their jobs. An exploratory, qualitative study of 12 HCWs, recruited from two states in the United States, found high levels of both structural and psychological empowerment among research participants, as well as a number of disempowering aspects of their job. Findings suggest ways to support elements of the work that HCWs find empowering and decrease elements that contribute to job dissatisfaction and turnover.     

Contested attachments: rethinking adoptive kinship in the era of open adoption

Since its legal inception in 1926, adoption work has been centrally concerned with the matter of the adopted child's ‘first’ or prior life, whilst also focussed on achieving a new and secure substitute family for that child. Adoptive kinship has been formed through this dual and contradictory concern, a concern that has produced diverse policies and practices over the last 90 years. Drawing on Foucault's concept of technologies of the subject, this paper is an exploration of adoptive kinship within the new context of open adoption, a set of practices that more actively promotes the involvements of the adopted child's former family. These practices both promote a radical reworking of adoptive kinship, as well as confirming its more orthodox moorings. Drawing on an adoption archive study, the paper concludes with an analysis of letterbox contact to explore how far this form of open practice transforms adoptive kinship in the contemporary era.     

Two's Company,Three's a Crowd: Revisiting Triangles in Family Therapy

In this article I would like to investigate the place of the couple in family therapy intervention. Within this I will look at the usefulness of the concepts of triangulation and triangles in families and as to whether it is a theory that translates to be useful in practice and in technique. Attention will be paid to both the experience of this phenomena and emerging theories of the mind which casts new light on the concept of the emotional triangle.     

Social Inclusion or Market Competitiveness? A Comparison of Rural Development Policies in the European Union and the United States

The language of EU rural development policy appears more interested in social inclusion and that of US policy more interested in market competitiveness. We seek to determine why policies directed at rural development in the EU and the USA differ. In both contexts new rural development policies emphasize partnership and participation but we find local participation is used to promote social inclusion in the EU and market competitiveness in the USA. An examination of these dimensions illustrates important transcontinental differences and similarities in rural development policies. We explore the socio‐historical reasons for differences in the commitment to social inclusion, while also noting similarities in the priority of market competitiveness.     

Social Work Student Views on Palliative Care Learning Resources

Abstract

Many social workers are expected to work with individuals and families who are dealing with life-limiting illnesses, yet during their university education they may not have been exposed to materials that address issues related to death and dying. The Social Work Department of University of New England in Armidale, Australia designed and delivered a palliative care teaching and learning session using publicly funded online materials. Themes emerging from questionnaire and focus group data analysis included appreciation for the importance and emotional demands of the materials, sensitivity and flexibility among educators who ideally have work experience in the field, expanding presence of social work philosophy in curriculum materials and exploring spirituality, and examining culture-informed practice in greater depth. Among the implications is the need for concerted efforts to teach about death and dying using high quality accessible materials, while ensuring social work values and approaches are reflected in the content.     

Auditing Nonphysician Providers' Visits through a Computer-Assisted System

Abstract

The Medical Department is using a computer-assisted system for auditing care provided by mid-level practitioners. Standards of care and corresponding checklist forms have been developed for six common ambulatory problem areas. These include: Respiratory complaints, headache, gastrointestinal disorders, urinary tract infections, male genitourinary problems, and minor trauma. The standards for the diagnostic process and treatment of each complaint were developed by a working group of physicians and mid-level practitioners. Providers complete a checklist form for each patient presenting with problems covered by the protocol. The checklist serves as the medical record for the visit. Checklist data is entered into a computer which audits the visit record against protocol standards. The computer identifies records containing discrepancies in the appropriateness of diagnosis, treatment plan, and physician consultation. The computer output is not the end of the audit process. It identifies encounter records which need further review. Because a discrepancy from the programmed standards does not necessarily reflect faulty medical judgement or care, these records are referred weekly to a physician-nurse audit team. The computerized system allows the auditors to focus their efforts on problems which may make a significant difference in patient care.

As a result, the Medical Department's audit process is both more comprehensive and more thorough than it was prior to the inception of this program. Since April 1, 1977, more than 15,000 encounters have been audited through this system.     

Responding to Self‐harm: A documentary Analysis of Agency Policy and Procedure

This paper reports on the findings of a documentary analysis of policies and procedures relating to self‐harm from a range of organisations working with young people in the UK. It identifies the extent to which policies and/or procedures relating to self‐harm are available for service providers and offers a wider understanding of the concepts of self‐harm and approaches to helping as incorporated into service guidance and delivery. It highlights the prevalence of self‐harming behaviours in a climate of stigma and the need to define appropriate and supportive agency responses from a trained staff that is both sensitive and individualised.     

A taxonomy of gambling and casino games via social media and online technologies

The increased popularity of casino games on social media platforms has prompted international jurisdictions to consider the extent to which these games may be similar to Internet gambling activities and therefore subject to regulatory action. Gambling themes are popular in video and computer games, and simulated-gambling activities are commonly offered by gambling operators as a way of enticing users to gamble online with money. However, little research has evaluated the impact of the digital convergence of gambling and gaming. The lack of a clear definition of online gambling-themed activities to guide such research undertakings represents a significant hurdle to the fields of gambling and gaming. Based on a review of the extant literature, this article proposes a taxonomy to distinguish between many types of online activities with gambling-themed content. This taxonomy suggests that the principal features that differentiate online gambling games include the requirement for payment, the role of skill, the type of platform and the centrality of the gambling theme. The proposed hierarchical framework aims to promote clear and consistent discussion to guide ongoing investigation of new and emerging Internet gambling and gaming technologies.     

Risk,interest groups and the definition of crisis: the case of volcanic ash

This paper considers a key aspect of the ‘risk society’ thesis: the belief that we should be able to manage risks and control the world around us. In particular it focuses on the interface between risk and risk events as socially constructed and the insights that ‘critical situations’ give us into ‘the routine and mundane’, the otherwise taken for granted assumptions underlying risk regulation. It does this with reference to the events precipitated by the April 2010 volcanic eruption in the Eyjafjallajökull area of Iceland. The resulting cloud of volcanic ash spread across Europe and much of Europe's airspace was closed to civil aviation for six days, with far reaching consequences including huge financial losses for airlines. The social processes of defining and reacting to risk and crisis both reveal and generate dilemmas and challenges in regulation. This paper examines the role of different interest groups in defining risk expectations and thereby redefining the ash crisis as a regulatory crisis.