Gail Adorno

Current unmet needs of cancer survivors: Analysis of open-ended responses to the American Cancer Society Study of Cancer Survivors II

Cancer survivors may continue to experience psychosocial and physical needs related to their cancer experience for many years after treatment. The specification of these needs across cancer types and by survivor characteristics may lead to better prevention approaches and clinical responses. Mixed methods were used to examine responses to an open‐ended question about current unmet needs from a survey of 2‐, 5‐, and 10‐year cancer survivors.

By Invitation Only: Social Work Involvement at the End of Life in Long-Term Care

ABSTRACT This qualitative study used three focus groups of long-term care social workers to determine how they viewed their roles with dying residents. Using grounded theory methodology, social workers were found to have difficulty articulating their roles; social work involvement occurred most often at the request of other staff, specifically nursing; hospice involvement contributed positively to end-of-life care but makes the social work role less clear; and elements of time and space influence the end-of-life experience for long-term care social workers, residents, and family members. Findings suggested that the social work profession must step forward in articulating the social work role and that research to validate the value of social work involvement is needed.

Understanding Quality-of-Life While Living with Late-Stage Lung Cancer: An Exploratory Study

U.S. Veterans have a higher prevalence of advanced lung cancer and poorer survival outcomes compared to the general population; yet, no studies exist which specifically explore the psychosocial and existential quality-of-life (QOL) of late-stage lung cancer among this population. This article presents the perspectives of older veterans (N = 12) living with late-stage lung cancer who were receiving chemotherapy, routine hospice care, or both concurrently. Based on individual interviews, themes associated with loss of functionality, close relationships, and communicative acts contributed to veterans’ perceptions of diminished or enhanced QOL while living with advanced disease. An overarching theme, loss of the person I know myself to be, suggests that personhood is an important concept to consider in QOL assessment. While findings suggest that the experiences of older Veterans with late-stage lung cancer are similar to other populations of lung cancer patients, and persons with incurable cancer in general, further research regarding the influence of veteran identity at end-of-life is warranted. Further research is needed which explores the influence of a whole person approach to QOL during life-limiting illness and end-of-life decision-making, particularly while receiving late-stage cancer-directed therapy.

An Analysis of Social Work Oncology Network Listserv Postings on the Commission of Cancer's Distress Screening Guidelines

This is a qualitative study of listserv postings by members of the Social Work Oncology Network (SWON) in response to the Commission on Cancers 2011 guidelines for distress screening of cancer patients. Archived listserv postings for the period of December 2010 to November 2011 were deidentified and a sample was derived by a list of keywords for the analysis. Aims of the study included describing the general categories and themes of the postings devoted to the new distress screening standard and examining the process of facilitation of mutual support and information exchange by oncology social workers in response to the new screening standards. During the 12-month timeframe there were 242 unique listserv postings sampled for the analysis. Oncology social worker (OSW) discussion of the distress screening guidelines remained a constant topic over the 12 months, and major themes that emerged from the data included processes of implementation of distress screening in cancer centers, screening policies and protocols, screening tool choice, and oncology social worker professional identity. The SWON listserv members used the listserv as a mechanism to post their requests for information on screening, to share their experiences in the beginning stages of implementing the guidelines, and to build support for legitimizing oncology social workers as the lead profession in the implementation of the guidelines in member cancer centers.

Exploratory Factor Analysis and Reliability of the Child Welfare Trauma-Informed Individual Assessment Tool

This article presents the development and psychometric analysis of the Child Welfare Trauma-Informed Individual Assessment Tool, an instrument designed to measure the extent to which child welfare service providers employ trauma-informed practices with the children and families that they serve. Using the responses of 213 front-line child welfare workers, exploratory factor analysis was used on a seventeen-item scale, resulting in a four-factor model. Based on the results of this analysis, implications for potential uses of the instrument are discussed, and specifications for additional evaluation of the measures validity are outlined.

Between Two Worlds: Liminality and Late-Stage Cancer-Directed Therapy.

Disease-directed therapy near death is a growing trend among persons living with late-stage cancer. As a sociocultural phenomenon, cancer-directed therapy (e.g., chemotherapy) when given for very advanced disease is a process that offers questionable benefits and portends further suffering, but also suggests potential for growth and transcendence. Theories and concepts drawn from cultural anthropology, sociology, and existentialism illustrate how contextual factors contribute to the creation of a “liminal space”; the latter part of the cancer trajectory where living and dying can overlap. When applied to clinical practice, this theoretical framework gives the patient, family, and health care provider a way of “unmasking” a period of transition during terminal illness when aggressive disease-directed care continues to be provided. The liminal space may function as an existential plane; a gateway or threshold with inherent potential for psychospiritual development during the final stage of life.

A different kind of animal: liminal experiences of social work doctoral students

Evidence suggests that social and academic integration is a vital factor in doctoral student retention. This paper describes findings from a qualitative study which explored the experiences of a cohort of social work doctoral students during the first year in their programme of study. We used the anthropological concept of liminality which describes disorientation through transformative rites of passage, as a sensitising concept, through which to interpret the data. Thematic analysis indicated that the transition into new doctoral student was characterised by uncertainty and chaos and left the participants in an ambiguous position, betwixt and between socially prescribed roles. The findings demonstrate the need for anticipatory guidance and structured, sustained support, particularly within students’ first year. Efforts to enhance cohort relationships and mentoring may also help.

Health Care Decision Making for Unbefriended, Incapacitated Adults: A Value-Committed Policy Transfer Analysis

ABSTRACT Adults who lack decisional capacity and known family or friends to serve as their health care agent are an increasing concern. This article examines the transferability of Texas and Florida legislation, which stipulates the persons eligible to serve as health care decision makers for unbefriended, incapacitated adults in the absence of an advance directive. Texas §313.004 allows for a clergyperson to serve in this role, whereas Florida Ann. §765.401 allows for a social worker with the requisite licensure or training. The authors provide a critical comparative value-committed analysis of the factors that influence state legislation that addresses the needs of unbefriended adults.

Advice from working women with retired partners

ABSTRACT In the 21st century, as more women are employed full-time and couples increasingly share egalitarian values, more women continue employment after their partners have voluntarily retired. However, we know very little about the experiences of this growing population of women. We asked working women with retired partners to share their advice for other women who may face this developmental transition. Open-ended responses from 97 women were analyzed to identify pertinent issues and themes. Four primary content areas were identified: time management, division of household labor, financial planning, and communication. Communication between partners was both a topic of concern as well as the solution suggested to resolve conflicts or differences that may arise when women live with a retired partner. It is expected that future changes in the workforce and improvements in the gender balance within relationships will continue to impact experiences for working women with retired partners.

Pathways to age-friendly communities in diverse urban neighborhoods: Do social capital and social cohesion matter?

ABSTRACT Using a social capital and social cohesion lens, we reposition the concept of civic engagement among older adults to examine pathways for building age-friendly communities. We analyzed data drawn from a Community-Based Participatory Research study in the Southern U.S. that explored lived experiences of older adults, age 55 and above, who participated in individual interviews (n = 15) and six focus group discussions (n = 45) to examine their perceptions of social identity, social connectedness, and civic engagement geared toward an age-friendly city. Findings indicated that several older adults had access to social networks and socially invested resources, thereby having opportunities for civic engagement and building age-friendly neighborhoods. However, social, cultural, linguistic, and structural barriers were more evident among certain diverse ethnic populations. Marginalized low-income minorities and immigrants, such as Hispanic participants, felt the lack of social cohesion among the larger society limited their ability to give back, thus decreasing their civic engagement activities. In contrast, Caucasian and African-American older adults were able to contribute to the political process through more civic participation activities. We provide implications for examining the role of social capital and social engagement to bolster civic engagement among older adults in building age-friendly communities.