Interprofessional team members' perceptions of palliative social workers' contributions to patient-centered care

Interprofessional collaborative practice (IPCP) is fundamental to the delivery of high-quality patient-centered care. An IPCP core tenet is that efficient and effective teams are crucial for the delivery of care that achieves patient satisfaction as well as positive patient-level outcomes. Although a growing number of IPCP studies explore how IPCP professionals work collaboratively, the vast majority focus on the interactions of physicians and nurses, few consider other professions or simply lump them into an “other” category. This qualitative study addresses this knowledge gap through the exploration of how hospital palliative care teams utilize the skills of advanced hospice and palliative care certified (APHSW-C) social workers to increase teams’ overall effectiveness. A two-step recruitment process was used to create matched samples of 17 palliative social workers and 24 interprofessional team members (i.e., physicians, nurses, physician assistants, chaplains). Using a constructivist grounded theory approach, semi-structured interviews were conducted, recorded, and transcribed. Analysis revealed six themes surrounding other profession's perceptions of social workers’ contributions: 1) providing continuity during and across admissions, 2) assessing and promoting the patient’s bio-psychosocial needs, 3) offering clinical expertise and support to patients with complex psychosocial needs, 4) allocating time to initiate, process and revisit difficult conversations with patients and families, 5) modulating the pace and intensity of emotionally laden conversations, and 6) supporting team well-being. Findings underscore that interprofessional team members view social workers as playing a significant role in developing, building, and sustaining a therapeutic alliance between the patient and the team.Published versio

High-quality patient-centered palliative care: interprofessional team members’ perceptions of social workers’ roles and contribution

https://doi.org/10.1080/13561820.2023.2238783Published versio

Fractured identity: a framework for understanding young Asian American women's self-harm and suicidal behaviors

Despite the high suicide rate among young Asian American women, the reasons for this phenomenon remain unclear. This qualitative study explored the family experiences of 16 young Asian American women who are children of immigrants and report a history of self-harm and/or suicidal behaviors. Our findings suggest that the participants experienced multiple types of "disempowering parenting styles" that are characterized as: abusive, burdening, culturally disjointed, disengaged, and gender-prescriptive parenting. Tied to these family dynamics is the double bind that participants suffer. Exposed to multiple types of negative parenting, the women felt paralyzed by opposing forces, caught between a deep desire to satisfy their parents' expectations as well as societal expectations and to simultaneously rebel against the image of "the perfect Asian woman." Torn by the double bind, these women developed a "fractured identity," which led to the use of "unsafe coping" strategies. Trapped in a "web of pain," the young women suffered alone and engaged in self-harm and suicidal behaviors.K01 MH086366 - NIMH NIH HHS; R34 MH099943 - NIMH NIH HH

The Nonprofit Sector's Responsiveness to Work-Family Issues

Although researchers have explored the growth and impact of family-supportive policies in the business sector, there has been a curious lack of attention to the development of family-responsive policies in the nonprofit sector. This article suggests possible explanations for the dearth of such studies, reviews the existing literature, and offers directions for future research examining the kinds of work environments and policies that attract and retain high-quality employees in nonprofit organizations. Such research is critical as a growing number of workers, both men and women, are seeking ways to balance a desire for meaningful work with a wish for fuller family or personal lives. </jats:p

Life Span: Oldest-Old and Advanced Old Age (After the Age 85)

As a result of rising life expectancies, America’s older population is itself aging. The U.S. Census Bureau projections suggest that, by the middle of the 21st century, more than 40% of Americans aged 65 and older can expect to live to at least the age of 90. Although the oldest-old (often defined as persons ages 80 and older or those ages 85-plus) is a diverse population, advanced old age is associated with a greater risk of experiencing economic hardship, disabling illnesses or health conditions, and social isolation. A growing public policy challenge will be ensuring the economic well-being, the health, and the dignity of society’s very oldest citizens.</p

Improving the Retirement Prospects of Lower-Wage Workers in a Defined-Contribution World

Lower-wage workers have always faced challenges in saving for their retirement years. As U.S. businesses increasingly adopt defined-contribution pension plans and emphasize individual responsibility and choice, what is the impact of this shift on the working poor? Lack of pension coverage is a significant concern because Social Security alone will not assure a comfortable retirement for lower-income workers. Our survey of more than 300 lower-wage service workers revealed that significant predictors of retirement savings behavior included greater financial literacy as well as greater job stability, stronger workforce attachment, and higher income. Employer-sponsored pension plans were the most frequently used savings option. Based on the findings, we explore the potential impacts of the Pension Protection Act of 2006 (PPA) on lower-wage workers' retirement security and propose policy steps to reduce the risk of poverty being recycled into postretirement years.</jats:p