Hospital-based social workers’ perceptions of generalist- and specialist-level palliative social work activities

Abstract

A social work advisory group recently proposed 41 generalist-level palliative social work activities applicable to any venue, including hospital-based social work, but this applicability has not been empirically tested. Therefore, we used critical realist grounded theory analysis of qualitative interviews to explore whether the activities proposed by the advisory group reflect inpatient social workers' perceptions of their generalist-level palliative activities when caring for patients alongside specialist-level palliative social workers. Fourteen Masters educated social workers from six hospitals in the Midwest United States participated.Corresponding concepts from interview data of hospital-based social workers' perceptions of what facilitates or hinders collaboration with specialist-level palliative social workers were identified and mapped onto the 41 generalist-level palliative social work activities. We used NVivo to organize and track data. Findings: Inpatient social workers find it challenging to engage in specific generalist-level palliative social work activities; provision of generalist-level palliative services is shaped by discharge planning duties, the consultation model, and the concentrated role of specialist-level palliative social workers. Competency in cultural and spiritual aspects of care could be lacking. Applications: Most of the 41 generalist-level palliative social work activities are present in hospital-based social workers' clinical practice. However, not all activities may be applicable or realizable in the inpatient venue. In the hospital, an emphasis on discharge planning and related time-barriers can mean seriously-ill patients and their families lack access to generalist-level palliative social work services. Clarification is needed about which of the 41 activities are relevant to and actionable within the inpatient venue.

How can social workers be meaningfully involved in palliative care? A scoping review on the prerequisites and how they can be realised in practice

“… 39 Furthermore, forms of peer-to-peer learning between skilled social workers and social workers new to palliative care can improve competence and confidence 40 , 41 or train skills that were not covered in undergraduate curricula. 8 , 33 …”

“…39 Furthermore, forms of peer-topeer learning between skilled social workers and social workers new to palliative care can improve competence and confidence 40,41 or train skills that were not covered in undergraduate curricula. 8,33 In practice, 'competence and confidence' is rather a product of undergraduate education, continuing education and so-called 'on-the-job learning'. 18,22,31,42 Given the increasing number of people with palliative care needs, the development of social work competencies should at best not solely rely on on-the-job-learning and continuing education.…”

“…On one hand, several authors have specifically suggested to include at least a minimum amount of general palliative care content in social work curricula. [30][31][32][33] On the other hand, authors have specifically mentioned that social work curricula should ideally include a mandatory and specialised component on palliative care. [34][35][36] A second path is to develop postgraduate or other continuing education opportunities for social workers.…”