The aim of this qualitative study is to examine the experiences of social workers in pediatric palliative care. In-depth interviews were conducted with eight social workers in pediatric palliative care clinics. Data were analyzed using content analysis, producing five themes. Findings show that social workers assume multifaceted roles. Social workers develop strategies to cope with the intense emotional labor involved. Despite being essential multidisciplinary team members, limited recognition and resources restrict their effectiveness. Social workers emphasized the need for specialized knowledge and skills in pediatric palliative care, but noted that limited training, mentorship, supervision, and systemic support restrict professional capacity.
Prioritizing referrals is a challenging and common task in hospital social work practice. However, it is not well understood what influences prioritization decisions. We drew on the psychosocial rationality model and fast-and-frugal decision trees to consider how Australian hospital social workers prioritize their referrals. In-depth interviews with 15 hospital social workers were completed. The qualitative analysis identified seven heuristics influencing decision-making: (1) imminent harm, (2) likelihood of death, (3) discharge status, (4) social workers' ability to help the patient, (5) risk factors, (6) protective factors, and (7) time needed to resolve the referral. Heuristics are simple to learn and provide assistance to social workers to enable them to make quick, transparent, and consistent prioritization decisions.
Social determinants of health (SDOH) have a powerful influence on health inequities. Studies have revealed associations between SDOH and health status and recovery from illness. Research on how social workers in healthcare advocate for awareness of the associations between SDOH and health status, or recovery from illness, is scarce, especially from an international perspective. Barriers to addressing SDOH in the social work in healthcare profession are also rarely systematically studied. This special issue aims to address this gap. It aggregates qualitative and quantitative studies that address the major roles SDOH play in different diseases, populations, contexts, and countries. However, the different research methods used do not allow for comparison of findings. The presented studies point to a lack of standardization in screening and addressing SDOH, as well as large discrepancies in institutional policies, regulations, and the status of health social workers. In conclusion, international dialogue and comparative longitudinal quantitative and qualitative studies are required to better understand the factors that enhance or diminish the impact of social workers in integrating SDOH into decision-making and routine care, as well as in crisis interventions in health settings.
BACKGROUND:Negative events in hospitals can deeply impact people receiving healthcare and their carers. Trauma-Informed Care (TIC) aims to promote safety, choice, collaboration, and empowerment, but gaps remain between these principles and the lived experiences of patients. METHODS:This qualitative study, led by hospital social workers, analyzed written complaints to an Australian general hospital during two three-month periods in 2019 and 2021. Complaints were categorized using traditional and trauma-informed frameworks, and thematic analysis captured the emotional aspects of these experiences. RESULTS:Among 61 complaints, issues were categorized into clinical, organizational, and relational concerns. However, a lack of TIC principles was identified in a higher percentage of complaints compared to these traditional categories. Five key emotional themes were identified: feeling unheard, misunderstood, uninformed, disrespected, and powerless.
This study aimed to examine the effect of competence on intention to quit among Chinese substance abuse social workers while also exploring the sequential mediating effects of role conflict and job burnout on this relationship. Data were collected from 668 substance abuse social workers participating in 21 community drug rehabilitation projects across 14 social work agencies based in Guangzhou, Shenzhen, Foshan, and Zhongshan in Guangdong Province, China. A cluster sampling method was utilized for data collection. Analysis was conducted using the SPSS and Model 6 of Hayes's PROCESS macro. The findings revealed that: (1) the direct effect of competence on the intention to quit was not statistically significant; (2) both role conflict and job burnout exhibited significant mediating effects between competence and the intention to quit, with a notable sequential mediation effect. It is essential to strengthen the training and supervision of substance abuse social workers to enhance their competence, while focusing on mediating role conflict and preventing job burnout. This approach is expected to promote team stability among substance abuse social workers and facilitate the high-quality development of community drug rehabilitation services.
Aging populations and persistent staff shortages driven by high turnover are putting long-term care (LTC) systems under growing pressure. Existing research has mostly examined the symptoms of this staffing challenge - such as job dissatisfaction - rather than its underlying organizational and governance structures. This article addresses that gap by examining how LTC reforms have reshaped the labor process and negatively affected care provision. We conducted a conceptual review of academic and policy literature in English, German, French, and Italian, combining interdisciplinary database searches with selected policy documents. Our analysis draws on a framework that combines critical perspectives on New Public Management, as well as labor process theory, and the "logic of care." We identify three mechanisms that generate tensions for LTC workers: the standardization of care into measurable tasks, intensified work with reduced autonomy, and the curtailment of relational care. We illustrate these dynamics through the case of Switzerland, where high levels of resources and care quality coexist with similar sectoral dysfunctions. Addressing staffing shortages in LTC will require structural and organizational reforms that better recognize and support the central role of relational care, which is crucial to both workers and residents.
Nigeria introduced Maternal and Child Health (MCH) programs to improve access to skilled care in response to persistently poor health outcomes among women and children. While existing assessments often emphasize the role of healthcare workers, the contributions of social workers and Community Health Extension Workers (CHEWs) remain largely overlooked. This study explores the roles played by social workers and CHEWs in enhancing access to MCH services through an intervention project in Anambra State, Nigeria. An exploratory qualitative design was employed, involving interviews with five social workers, ten healthcare workers, and three CHEWs. Thematic analysis revealed that both groups were instrumental in mobilizing pregnant women and other community members to utilize antenatal and postnatal services, facility-based deliveries, and basic noncommunicable disease care. Social workers, in particular, reported feeling undervalued despite their contributions to community health work. The findings underscore the importance of integrating social workers and CHEWs into strategies aimed at increasing demand for MCH services. This has significant implications for evidence-based policy development and health program planning in Nigeria. The study recommends the formal inclusion of social workers and CHEWs in MCH initiatives to strengthen community engagement and improve health outcomes.
This study examines social support, mental well-being, and health-seeking behavior among 226 African immigrant women in Türkiye using the Multidimensional Scale of Perceived Social Support (MSPSS), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and Health Seeking Behavior Scale (HSB). Participants reported moderate social support (M = 4.92), average mental well-being (M = 3.22), and modest health-seeking behavior (M = 3.08). Social support improved mental well-being (B = 0.106, p < .001) but reduced health-seeking behavior (B = -0.220, p < .001). Social work practice should promote culturally sensitive support systems to enhance healthcare access. These findings highlight the role of clinical social workers in designing evidence-based interventions that support mental well-being and promote equitable healthcare access for immigrant women.
The COVID-19 pandemic upended healthcare in the United States, profoundly impacting the mental and physical health of children and adolescents. This study examined how referrals to psychosocial services in a freestanding children's hospital emergency department changed during the initial COVID-19 state of emergency period in Massachusetts when compared to a previous period of similar length. While the total number of emergency department encounters decreased during the COVID-19 period, there were significant increases in rates of referrals for social work support across general, psychiatric, and child protection needs. Social workers played a critical role addressing children's needs during the COVID-19 crisis.
This article explores the complex role of medical social workers (MSWs) in addressing structural determinants of health among unidentified and homeless patients within India's public health system. Drawing on grounded field experiences, it reveals how MSWs act as crucial intermediaries navigating institutional apathy, legal ambiguity, and human rights obligations to uphold dignity and ensure care. The study highlights how caste, poverty, mental health stigma, and systemic neglect intersect to deepen marginalization. It further examines the strategies employed by MSWs to mitigate these inequities, including advocacy, ethical negotiation, and inter-sectoral coordination. By foregrounding MSWs' practice-based knowledge, this study contributes to limited empirical literature on social work interventions with unidentified patients and underscores the need for clearer institutional protocols, legal safeguards, and policy recognition of MSWs as central actors in advancing health equity within public healthcare systems in India.
This article examines the role of health social workers (HSWs) in implementing emergency bed-reduction policies in Israel, with a focus on their efforts to safeguard continuity of care and promote health equity during the Iran - Israel war (June 2025). Using a qualitative design, we analyzed administrative notes from a real-time telephone survey with 17 heads of hospital social work services, alongside seven follow-up interviews. The analysis yielded two central themes: (1) Challenges arising from emergency discharge and bed-reduction policy, including institutional barriers, limited community care options, and patient- and family-related obstacles that undermine continuity of care; and (2) The role of HSWs in navigating structural gaps and ensuring equitable transitions of care, through bridging fragmented systems, participating in emergency decision-making, and advocating around social determinants of health. Findings show that under emergency discharge conditions, HSWs moved beyond routine coordination to engage in ethical logistics, systemic navigation, and advocacy for vulnerable patients. In so doing, they acted as "bureaucratic activists," reshaping institutional practices from within, safeguarding equity, and alleviating pressures on the healthcare system. The discussion outlines practical recommendations for policy and practice, emphasizing the need to position HSWs in a leadership role at the center of discharge planning during crises.
This study explored the perspectives of social workers from addictions field regarding payment for sex (PS) and the associations with self-efficacy, comfort to discuss sexual issues in treatment (CDSIT), and attitudes toward social justice, toward people who receive payment for sex (PRPS) and toward PS. Participants (N = 123) completed an online questionnaire. Main findings showed that while most acknowledge the significance of addressing PS with clients with substance use disorder, they often did not do so in practice. Attitudes toward social justice, attitudes toward PRPS (perceived as victims rather than choosers), and CDSIT were key predictors.
The prevalence of drug use has emerged as a pressing public health concern, particularly in Hong Kong, where hidden drug use negatively affects mental health and family relationships. This quasi-experimental study investigated the effectiveness of family-based treatment for adults using psychotropic drugs in community settings. Significant reductions in drug use frequency (Cohen's d = 0.459, p = .010,) and improvements in mental health (Cohen's d = 0.634, p = .000) were observed. The findings underscore the critical role of family involvement in addressing drug use issues, highlighting the need for social work interventions that not only focus on the individual but also engage family members as active participants in the recovery process.
Latino communities in the U.S. experience disproportionately high rates of prediabetes and type 2 diabetes yet remain underrepresented in prevention programs. This qualitative study conducted a needs assessment with 70 Latino adults at risk for diabetes in Los Angeles, recruited via Instagram and local community events. Barriers to prevention included limited accessible information, low program availability, and cultural influences and stigma. Facilitators included program flexibility, incentives, Spanish-language services, and financial assistance. Findings highlight culturally responsive and equitable strategies for social workers to effectively engage Latino populations in diabetes prevention and management.
This study aimed to explore the role of social workers in the care and management of drug and substance abuse within an interprofessional psychiatric environment, focusing on their practice experiences, challenges, and professional positioning. Using Interpretative Phenomenological Analysis (IPA), the study engaged 10 purposively selected social workers from Harare Psychiatric Hospital, Zimbabwe's largest mental health institution. Data were collected through semi-structured interviews and analyzed in two phases: initial coding using MAXQDA software, followed by manual interpretation to identify superordinate themes. Findings revealed four key roles: (1) conducting psychosocial assessments that are often excluded from team decisions; (2) attempting to link patients with community-based rehabilitation services despite weak referral systems; (3) engaging families in recovery processes, often without institutional recognition; and (4) advocating for holistic, non-medical interventions that are frequently dismissed by clinical teams. The study concludes that social workers are essential yet undervalued actors in substance abuse care. Their marginalization undermines both patient outcomes and the effectiveness of interprofessional collaboration. Recommendations include integrating social work assessments into treatment planning, strengthening reintegration systems, institutionalizing interprofessional training, auditing policy implementation, and enhancing the resourcing of social work units to support sustainable recovery outcomes.
This study evaluated the effectiveness of training peer supporters in “Walk with Me”, a peer support program for youths with or at risk of non-suicidal self-injury (NSSI) in Singapore. Using a pre-post design with 76 peer supporters aged 19-35, the study examined program outcomes and mechanisms of change. Results demonstrated significant improvements across all six outcomes for peer supporters: empathetic support awareness, self-efficacy, NSSI knowledge, attitudes toward NSSI, advocacy abilities, and empowerment to effect change. Key mechanisms were supported, showing that awareness improvements predicted self-efficacy gains and knowledge increases predicted more positive attitudes. Participants rated the program highly helpful with the two-day training component most valued. Findings illustrate how social workers can design peer support programs that create pipelines of trained community members equipped to challenge stigma and promote social inclusion.
Interdisciplinary collaboration is a foundational principle of palliative care, yet social workers within these teams often encounter professional marginalization, role ambiguity, and systemic barriers to full integration. This study explores the experiences of palliative care social workers in Ontario, Canada, focusing on the tensions they navigate within interdisciplinary teams. Using an interpretive qualitative approach, in-depth interviews were conducted with 13 social workers practicing in hospital and community-based palliative care settings. Thematic analysis identified three interrelated themes: social workers' understandings of their professional role within palliative care teams; their perceptions of how their role is viewed by other professionals; and the discordance between internal professional identity and external recognition. Across these themes, participants described experiences of role devaluation, constrained professional autonomy, and conflict between anti-oppressive social work approaches and dominant biomedical norms.
Advance care planning (ACP) is a communication process whereby capable individuals can express, discuss, and document their thoughts, values, and wishes as they relate to their future health care. ACP conversations are now widely recognized as a critical part of providing person centered, holistic care to patients at all points in their health-care journey. Social workers (SW) are uniquely situated to lead these important conversations. A cross-sectional online survey was made available to all registered wocial workers in Ontario, Canada, through the Ontario College of Social Workers and Social Service Workers (OCSWSSW) to explore practice characteristics as they relate to ACP conversations (n = 159). The research team sought to identify similarities and differences in ACP conversations with social workers practicing within Ontario and to answer what social workers' practice patterns are when engaging in ACP conversations in hospital and community settings. We aimed to examine contextual and respondent characteristics (practice setting, years of experience) and ACP training with view to apply results to make training, onboarding, and practice recommendations for ACP conversations for clinicians and trainees. Eligible social workers had access to the survey via the OCSWSSW website. Participants were also contacted via e-mail through professional associations, including the Ontario Association of Social Workers and invited to participate. The survey instrument, created by the research team, included three stages of design and testing. Results of the survey indicated that hospital social workers were significantly more likely to report participation in ACP conversations compared to those working in a non-hospital setting (56.5% versus 20.8%, respectively, p < 0.001, two-sided Fisher's exact test). There was also a significant association between having received ACP training and reporting participation in ACP conversations in practice setting (p < 0.001, two-sided Fisher's exact test). Specifically, 48.8% of those who received ACP training reported engaging in ACP conversations in comparison to 27.9% who did not receive any ACP training. Thematic analysis of responses also indicated the importance of patient and family readiness as a critical factor in practicing ACP. Future research should look to examine types of ACP training and its impact on ACP practice, the role of ACP for community social workers, and specific approaches for supporting patients and families at different stages of readiness for these important conversations.
The study applies Strong Structuration Theory to explore how informal carers' external structures (the size and quality of their social support network [SN]) influences their internal structures (caregiving network [CN] and levels of digital competence [DC]), action (caregiving hours per week [CH]), and outcomes (health-related quality of life [QL], burden of care [BC], and loneliness [Lo]). Two hundred informal carers of patients with chronic health issues were recruited and assessed, with a mean age was 59.2 ± 12.3 years (range: 25-86). Most were female and married; slightly more than half were the care recipient's children, 19.1% were spouses, 8.1% were siblings, and 7% were sons-/daughters-in-law. Conditional process analysis indicated a positive association between SN and CN, along with a chain mediation from CN to CH, BC, and QL that reduced loneliness. Overall, carers' external structures shaped their internal structures and actions, yielding both positive and negative outcomes. Digital competence moderated the relationship between CH and BC, reducing BC and loneliness. Social workers and healthcare practitioners should implement technology-based interventions to strengthen carers' social connectedness and mitigate the negative effects of caregiving.
Social participation significantly contributes to an individual's wellbeing, and it is particularly crucial for older adults who have lost their spouse. Using cross-sectional data of the China Health and Retirement Longitudinal Study (CHARLS 2018), this paper employs a logit model to examine the effects of widowhood, social participation, and their interaction on the health of the elderly. The findings indicate that social participation has a more pronounced positive effect on the health of widowed elderly individuals and can mitigate the health problems associated with widowhood. The findings indicate that social participation has a more pronounced positive effect on the health of widowed elderly individuals and can mitigate the health problems associated with widowhood.
