Mary Sormanti

Advancing social work practice in end-of-life care.

Abstract Insufficient training of health professionals has often been cited as a major barrier to improving the system of care for dying patients and for the bereaved. Although specific problems have been identified for physicians and nurses, the problems of social work in this substantive area have only recently been explored. This study used a practitioner survey, focus groups, and a survey of faculty of schools of social work to broaden the information base. Results suggested that not unlike the professions of medicine and nursing, social work knowledge and skill development in the care of the dying is uneven and not integrated sufficiently with theoretical concepts and research. Social workers felt unprepared for this work by their masters level training and unsupported by continuing education programs. They recognized few social work scholars who could function as role models by providing comprehensive training, knowledge building, innovation, and advocacy. A program for leadership development was created to test new approaches to professional development in the care of the dying and the bereaved.

WOMEN COPING WITH CANCER

Using a perspective based on relational theory, the influence of several relationship factors on womens adjustment to cancer was examined in 49 cancer patients, all mothers with young children. The results indicated that women who report higher mutuality, fewer self-silencing beliefs, and fewer coping strategies of protective buffering experience a more positive psychosocial adaptation to cancer.

Predictors of condom use and HIV testing among midlife and older women seeking medical services.

Objectives: This study examines correlates and predictors of sexual HIV risk reported by a sample of midlife and older women (M age = 56.01 years, SD = 4.34). Methods: In sum, 1,280 participants were recruited from primary health clinics and a hospital emergency department. Results: Of those women in a heterosexual relationship (n = 623), 73% reported having vaginal sex in the past 6 months. Only 12% of these women reported always using a condom during vaginal sex; 45% reported having been tested for HIV. Logistic regression analyses revealed that condom use is associated with more education, being employed, living with a partner, and being HIV positive. HIV testing is associated with being younger, unemployed, and not living with a partner. Discussion: These results (a) demonstrate that midlife and older women are at risk for HIV/AIDS and (b) contribute to a growing understanding of the risk picture involved with such women.

Partner support and changes in relationships during life-threatening illness : Women's perspectives

Abstract This study examined the role of the primary partnered relationship as a factor in womens adjustment to cancer. Data from semistructured interviews with 40 women, in combination with their scores on a standardized measure of the mutuality of the relationship, allowed for an investigation of the following questions: How do women with cancer perceive the effect of their illness on their primary partnered relationship? What types of support do women receive from their partners during the illness experience? Is this support adequate? What is the relationship between the mutuality of the primary partnered relationship and the support provided by the partner? The results indicated that the type of support the partner provides as well as the mutuality of the relationship contribute positively to womens coping. Thus, the mutuality of womens primary partnered relationships should be assessed routinely, and psychosocial interventions should sensitize couples to the benefits of enhanced mutuality during the illness experience.

Considering HIV risk and intimate partner violence among older women of color: A descriptive analysis

ABSTRACT This study describes the types of intimate partner violence (IPV) and sexual HIV-risk factors reported by a sample of 139 African American and Latina women ages 50 and older receiving care in outpatient clinics of an urban medical center. Additionally, we obtained estimates of the associations between experiencing IPV in a primary heterosexual relationship and the following HIV-risk behaviors among our sample of older minority women: (a) having multiple sexual partners, (b) STD history, (c) partner-related risk (i.e., having a partner who has multiple sexual partners, is HIV-infected, injecting drugs, and/or has an STD), and (d) self-perception of risk for HIV infection. Results indicate that many of these women are engaged in sexual risk behaviors, and such behaviors are associated with increased likelihood of IPV for this cohort. Implications for health care professionals are discussed.

Fieldwork instruction in oncology social work: Supervisory issues.

This article reports a study of supervisory issues that are unique to working with social work students who are placed in an oncology setting. The author used focus-group methodology to interview 10 female supervisors from hospitals in the greater Boston area whose mean number of years in oncology was 10.5 years. Three main themes emerged during the interview. One, oncology social work is different from and perhaps more difficult than social work in other settings; thus, supervision of beginners differs from supervision of beginners in other specialties. Two, the problems in oncology are difficult to grapple with; therefore, a certain type of student is required to do the work well. Three, gaps in the curricula of schools of social work have a negative impact on the total learning experience of students in oncology and other medical settings. The group also discussed concerns that students bring to supervision, including somatic reactions, dissynchrony with peers, and countertransference. The author offer...

Strengthening Grief Support for Children with Developmental Disabilities.

Although a sizable literature investigates and describes children’s grief, the majority of information focuses on typically developing children. Far less has been published about the loss and grief of children with developmental disabilities (DD), even though this population experiences significant and multiple losses, increasing their vulnerability to negative outcomes. Addressing this gap in scholarship, this article explicates common losses and important grief-related challenges experienced by children with DD. An overview of practice guidelines is provided to enhance the efforts of school-based mental health professionals in supporting this vulnerable population.

Identity and the Illness Experience: Issues Faced by Mothers with Cancer

Facing a life-threatening illness such as cancer can lead a woman to reevaluate her identity and the meaning of her existence. Utilizing a relational perspective, this study examined changes in identity experienced by a sample of mothers with cancer. Qualitative data on forty-one women were collected utilizing a semistructured interview schedule. While the theme of relationships was interwoven throughout their self-descriptions, the womens responses varied regarding how they managed their relational activities during their illness. Most respondents reported having positive feelings about who they were despite the often difficult impact that the illness and treatment had on their family roles. Many also reported that their experience with cancer had changed their sense of identity by causing them to reprioritize what was important and by revealing their personal strengths. Suggestions for health care professionals to assist women with cancer in coping with identity-related issues are offered.

Intimate partner violence screening in the emergency department: U.S. medical residents' perspectives.

Intimate Partner Violence (IPV) is physical, psychological, or sexual harm committed by a current or former partner, spouse, boy/girlfriend. In the United States, the National Center for Injury Prevention and Control (2003) estimates that 1.5 million women experience physical assault each year while the lifetime prevalence rate of IPV for women reaches almost 30%. Given the frequency and range of injuries and other health-related problems that result from IPV, the medical system shows promise as a central source of service provision for large numbers of abused women and their children. However, identification rates of IPV in many medical settings are low. This article describes a study that examined focus group data from 25 physicians in residency training at an urban hospital in the United States. Physicians discussed their knowledge and attitudes about IPV screening in the emergency department (ED) setting and suggestions to address perceived barriers to such screening. These data depict multiple barriers to physician screening of IPV in the ED. Findings substantiate previous research and provide new direction for enhancing IPV identification, referral, and treatment mechanisms in the ED setting including alternatives to physician mandated universal screening.

Strengthening the Interdependence of Palliative Care and Social Work

This special issue of Families in Society is focused on the robust intersections of social work knowledge, values, and skills with palliative care, a comprehensive approach to health care for people of all ages who are living with or affected by serious, life-threatening illnesses, at any point along the disease continuum and in combination with other disease-related treatments. Over the past several decades, as the evidence base of its benefits has grown steadily, the scope of palliative care has also expanded, moving it from the relative fringes of medicine to the center stage of interprofessional health care and humanitarianism. This is very good news for the tens of millions of children and adults that are conservatively estimated to need this care now (Connor & Bermedo, 2014) as well as for the markedly larger number of people that are projected to need it in the next few decades (Etkind et al., 2017). An ample body of rigorous research now documents that palliative care not only improves symptom burden and quality of life, but can also minimize unnecessary use of health services, including hospital admissions; shorten the length of hospital admissions when they occur; and reduce hospital costs. In addition to better outcomes for patients and cost effectiveness of care (Spilsbury & Rosenwax, 2017), some findings indicate that when palliative care is provided early in the course of illness, it might even extend survival (Temel et al., 2010). In short, research has demonstrated that superior care can cost less (May et al., 2018). Social workers, who have been long-standing champions of palliative care through the realms of advocacy, policy, public and professional education, research, and direct service to individuals and families, are key members of interdisciplinary palliative care teams and have been essential to the achievement of these outcomes. As a profession, we can—and should—be proud. Nevertheless, there are significant barriers to the ongoing development and implementation of appropriate and equitable palliative care both in the United States and across the globe. Not surprisingly, true to the profession’s guiding values, principles, and aims, social workers are at the forefront of multipronged efforts to identify and address the challenges and gaps related to palliative care provision and access. The articles in this special issue exemplify, elucidate, and advance these efforts. Opening the collection are two manuscripts that utilize the scoping review methodology to consider an issue and a population, respectively, that are of particular concern to social workers. Gardner and colleagues analyze U.S.-based study findings about barriers and disparities in access to or use of palliative care among adults who are members of racial and ethnic minority groups. Petruik focuses on the relatively small and nascent literature about social work practices in palliative care with people who experience homelessness. Following 811684 FISXXX10.1177/1044389418811684Families in SocietySormanti and Wong-Kim editorial2018