Pamela J. Kovacs

Age-Related Variation in Roles Performed by Hospice Volunteers

This study examines age-related variation in the roles performed by volunteers in hospice pro grams. Volunteers of varying age groupings display much similarity in their motivations for vol unteering, how they learned about the opportunity to serve, the levels of satisfaction experienced from serving, and various measures of retention. The age of the volunteer significantly influ enced the roles they performed at the hospice. Significantly more younger volunteers provide direct patient care services; and significantly more older volunteers provide both clerical and fund-raising services. Implications for future research and recruitment and retention of hospice volunteers are discussed.

Family-centered care: a resource for social work in end-of-life and palliative care.

Abstract Recent trends in medicine reflect an attempt to be more patient-centered and while this is progress from the disease- or provider-focused model familiar in healthcare, the experiences and contributions of family as caregivers continue to be overlooked in some settings. The family-centered care model, developed most notably in pediatrics, but emerging in HIV, cancer, and aging, is presented as a resource to increase family involvement at the end of life. In this paper, family-centered care is defined, caregiving trends including support needs of formal and informal caregivers are discussed, and barriers to family-centered services are identified. Reintroducing family into the focus of care at the end of life is the primary goal of this paper. The family-centered model of care offers an appropriate framework for understanding the value of family in end-of-life care and fits well with social work perspectives that understand individuals in the context of their family system and greater environment.

BEREAVEMENT SERVICES IN ACUTE CARE SETTINGS

Families of acute care patients who die while receiving care face loss and grief in unfamiliar institutional environments. Informal bereavement assistance may occur in acute care settings, but formally organized service and planned follow-up work with bereaved family members is less common. A literature review revealed little discussion of acute care-related bereavement services. The detrimental effects of long term, unresolved grief, however, are well-documented. Bereavement services help to reduce immediate physical and emotional distress while ameliorating long-term morbidity associated with unresolved grief. They may also reduce eventual costs for services and discomfort of illness by reducing the likelihood of stress-related illnesses occurring among survivors. Health care workers such as social workers, psychiatrists, chaplains, and nurses, who are familiar with the psychosocial needs of families and the structure and staffing of these settings, are well-positioned to organize assistance for those experiencing sudden loss. Developing a formal bereavement program in acute care settings involves description of the need, presenting the rationale for the service, identification of program elements, and determination of resource needs. Even in situations in which full services may not be possible, the provision of basic assessment and referral services will be beneficial to survivors while offering the institution several benefits.Families of acute care patients who die while receiving care face loss and grief in unfamiliar institutional environments. Informal bereavement assistance may occur in acute care settings, but formally organized service and planned follow-up work with bereaved family members is less common. A literature review revealed little discussion of acute care-related bereavement services. The detrimental effects of long-term, unresolved grief, however, are well documented. Bereavement services help to reduce immediate physical and emotional distress while ameliorating long-term morbidity associated with unresolved grief. They may also reduce eventual costs for services and discomfort of illness by reducing the likelihood of stress-related illnesses occurring among survivors. Health care workers such as social workers, psychiatrists, chaplains, and nurses, who are familiar with the psychosocial needs of families and the structure and staffing of these settings, are well-positioned to organize assistance for those experiencing sudden loss. Developing a formal bereavement program in acute care settings involves description of the need, presenting the rationale for the service, identification of program elements, and determination of resource needs. Even in situations in which full services may not be possible, the provision of basic assessment and referral services will be beneficial to survivors while offering the institution several benefits.

Informal Caregivers of Cancer Patients: Perceptions About Preparedness and Support During Hospice Care

This study examined the perceptions of preparedness and support of informal caregivers of hospice oncology patients. Respondents included coresiding, proximate, and long-distance caregivers. Thematic analysis was used to analyze the qualitative data from 2 caregiver surveys, one administered prior to the care recipients death and another completed 3 months postdeath. Respondents (N = 69) interpreted preparedness broadly and identified multiple sources of support including hospice personnel, family, friends, neighbors, and spiritual beliefs. Additionally, informational support, such as education, information, and enhanced communication were considered essential for preparing and supporting caregivers. Implications for social work research and practice are provided.

Writing a Mixed Methods Report in Social Work Research

This article briefly chronicles the development of mixed methods research and its use in social work. We then move onto a discussion of terms and designs, reasons for (and for not) using mixed methods. Drawing upon exemplars, we address how to write up a mixed methods study when (1) the sample is single; single for one part, with a subset for the other; or, there is more than one sample; (2) the timing is concurrent or sequential; and (3) the priority or weighting is equal or weighted toward one method or the other (qualitative or quantitative). In addition we address the Discussion section of a mixed-methods article as an opportunity to integrate the qualitative and quantitative data for readers.

Goodness of fit: social work education and practice in health care.

Abstract This study addresses the fit between social work education and practice in health care. A random sample of NASW members identifying with health care (N = 179) responded to a mail survey about the utility of core knowledge and roles that we had identified by reviewing seven commonly used health care social work texts. Quantitative data revealed knowledge and roles most frequently used in health care settings as well as differences in roles used dependent upon department name; and different professionals supervising social workers. Qualitative data from four open-ended questions provided suggestions for what knowledge and skills should be taught in social work programs, the best forums/methods for teaching this content, and topics for continuing education. Findings are discussed in relation to six key areas of the peer-reviewed literature: vulnerable populations/diversity, ethical dilemmas, interdisciplinary collaboration, mental health, managed care/accountability, and advocacy. Implications for social work practice, education, and research are discussed.

Participatory action research and hospice: a good fit.

ABSTRACT While research has always been an important component of the hospice movement in this country, increasingly hospices are involved in research as a result of demands for outcome measures and greater accountability. In addition to the more traditional research strategies, hospice researchers are encouraged to use participatory action research (PAR) in their efforts to better understand, document, and evaluate services. This article describes PAR and provides an example of a modified usage of PAR with a hospice program serving persons with AIDS. Whether used primarily in the planning phase of research or in conducting and reporting results as well, PAR maximizes input from those who know hospice best-staff, volunteers, patients, and caregivers. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]

Hospice research: Challenges, opportunities and rewards

Hospice and research have had a long-standing and, at times, strained relationship. Early studies, most notably the National Hospice Study, were instrumental in the passage and ongoing support of the hospice Medicare benefit and the growth and development of the hospice movement in the United States. Increasingly, hospices are involved in research as a result of managed care and other demands for outcome measures. Yet, it is often difficult to define and measure much of what hospice is about—quality of life, social support, interdisciplinary intervention. This article discusses some of the ethical, organizational, psychosocial, and physical challenges inherent in hospice research; identifies research opportunities through collaborative efforts with team members, other hospices, and university researchers; and illustrates some of the rewards associated with hospice research.

Working with families in which a parent has depression: A resilience perspective.

The association between parental depression and child maladjustment is well documented in the literature. Less is known about the strengths and potential protective mechanisms that help promote resilience for this population. This literature review addressing resilience in families was conducted to help inform policy and practice for families living with parental depression. Five protective factors—goodness of fit, self-esteem and self-efficacy, social support, family functioning, and opportunities for change—and four practice principles—discovery of resources and abilities, explanation of risk and protective factors, development of collaborative family relationships, and social support—emerged from this review. Implications for policy and practice in light of these principles are provided.

Developing a Community–University Partnership for Intergenerational Programming: Relationship Building is Key

Several factors converged to facilitate a community–university collaboration between William Byrd Community House (WBCH), Better Housing Coalition (BHC), and Virginia Commonwealth University (VCU) School of Social Work in Richmond, Virginia. This case example illustrates the initial development phase of a collaboration that starts and remains community based. This project creates opportunities for students and faculty to engage in program development with two community agencies. An overview of the factors that converged to shape this partnership, including a literature review on intergenerational programming that fosters joint learning, is followed by lessons learned about the importance of relationship building in these partnerships.