Establishing core competencies, opportunities, roles and expertise for oncology social work

Summary While oncology social workers are the primary providers of psychosocial services, they vary in what they do and how they work across different cancer care settings. Standards of Practice suggest that there exists a core or universal set of activities and tasks that are grounded in the values and principles of social work and apply across all settings. The purpose of this study was to identify activities that delineate and distinguish Competencies, Opportunities, Roles and Expertise (CORE) for oncology social work. Research was conducted using Concept Mapping, a structured and prescribed approach to collecting, analyzing, and interpreting qualitative and quantitative data while engaging stakeholders in the research process. Findings An expert panel of oncology social work practitioners, academicians, and leaders in the field (n = 35) generated 91 practice behaviors that were subject to card sorting and ratings of importance. A visual map consisting of six clusters best represented the statistical fit of the data (stress value = 0.18) while maintaining the most meaningful categorization of individual statements. These six domains were as follows: Clinical Assessment and Intervention (38 items; mean importance = 3.31); Professional Advocacy and Political Action (5 items; mean importance = 3.03); Case Management and Care Coordination (16 items; mean importance = 3.02); Patient Education and Advocacy (8 items; mean importance = 2.82); Organizational Support and Service (12 items; mean importance = 2.74); Professional Education (12 items; mean importance = 2.45). Application These results may inform initiatives related to social work education and training, credentialing and certification, health policy, research and advocacy on behalf of patients, families, communities, and the profession.

Pelatihan Manajemen Stress Kepada Penderita Penyakit Kronis di Desa Warisa

ABSTRAK Penyakit kronis yang telah diderita selama bertahun-tahun dapat mengganggu pada semua aspek kehidupan penderitanya seperti masalah finansial, Karir, gangguan peran, termasuk masalah psikososial, akibatnya, penderita penyakit kronis seringkali juga mengalami stress kronis yang selanjutnya dapat memperburuk penyakit dan menurunkan kualitas hidup penderitanya. Di Desa Warisa didapatkan jumlah penderita penyakit kronis sebanyak 83 Orang hanya dari 3 jaga (lingkungan). Tujuan Pengabdian Kepada Masyarakat ini adalah untuk meningkatkan pengetahuan dan kemampuan penderita penyakit kronis di Desa Warisa terkait manajemen stress melalui kegiatan pelatihan. Kegiatan ini dilakukan dengan memberikan penyuluhan terkait manajamen stress yang baik dilanjutkan dengan pelatihan manajemen stress dengan relaksasi napas dalam dan relaksasi otot progresif. Kegiatan ini diikuti oleh 29 peserta termasuk 2 kader dan dari hasil evaluasi didapatkan peningkatan pengetahuan peserta sebesar 22.4% yaitu sebelum penyuluhan (63%) dan setelah penyuluhan (85.4%). Dari hasil observasi juga didapatkan sebagian besar peserta mampu melakukan kembali gerakan latihan relaksasi otot progresif secara mandiri namun, ada 5 Peserta yang belum mampu melakukan gerakan latihan secara mandiri yang kemudian diberikan pendampingan lanjutan. Hasil dari kegiatan ini diharapkan dapat menjadi dasar pembentukan program kesehatan jiwa di puskesmas khususnya terkait pelayanan psikososial bagi penderita penyakit kronis. Kata Kunci: Manajemen stress, Penyakit kronis, Relaksasi otot progresif ABSTRACT Chronic illness that has been suffered for years can interfere with all aspects of people with chronic illness such as financial problems, career, role performance, and psychosocial aspects. as a result, People who suffer from chronic diseases often experience chronic stress that worsens disease severity and reduces the quality of life. In Warisa Village, there were 83 people who were identified with chronic diseases from only 3 hamlets. The purpose of this Community Service was to increase the knowledge and ability of People with chronic disease in Warisa Village regarding stress management through training. This activity was carried out by delivering health education related to positive stress management followed by stress management training with deep breathing relaxation and Progressive Muscle Relaxation (PMR). This activity was attended by 29 participants including 2 Cadres and from the evaluation process, it was found that the participants' knowledge increased by 22.4% in which before counseling (63%) and after counseling (85.4%). From the observations, it was also found that most of the participants were able to perform PMR independently, however, there were 5 participants who had not been able to perform PMR independently and were then given further assistance. The results of this activity are expected to be the first step to developing mental health programs in Community Health Centers, especially related to psychosocial services for people with chronic diseases. Keywords: Stress management, Chronic illness, Progressive Muscle Relaxation

Patterns of Gender-Based Violence in Conflict-Affected Ukraine: A Descriptive Analysis of Internally Displaced and Local Women Receiving Psychosocial Services

Since 2014, a protracted armed conflict has afflicted eastern Ukraine, resulting in the displacement of over 1.4 million residents. The resulting humanitarian crisis has placed women, particularly displaced women, at greater risk of gender-based violence (GBV). In Ukraine, reports of GBV were higher following the start of the conflict (22.4% in 2014 vs. 18.3% in 2007), with displaced women suffering from GBV nearly three times more than non-displaced residents (15.2% vs. 5.3%). Many GBV incidents in Ukraine have been reported along the “contact line,” the border separating government from non-government-controlled areas. This study compares types of GBV experienced by displaced and local (non-displaced) women receiving psychosocial support in order to identify the gaps in services during a time of conflict. Data was collected by mental healthcare providers from 11,826 women (25.5% displaced; 74.5% local) aged 15 to 69 receiving psychosocial services in five conflict-affected regions from February 2016 to June 2017. Group differences were assessed using Pearson’s chi-squared or Fisher’s exact tests for categorical variables and Wilcoxon rank-sum tests for continuous variables. Overall, almost half of the women experienced intimate partner violence and psychological abuse. Compared to residents, displaced women were more likely to report non-domestic GBV incidents involving sexual and economic violence. Almost 8% of violent incidents against displaced women occurred at checkpoints or at reception centers for internally displaced persons (IDP) and 20% were perpetrated by armed men. Consistent with the literature, this study suggests that displaced women are more vulnerable to attacks by persons outside the home and by armed groups. Our findings underscore the need to expand violence prevention programs to address the unique vulnerabilities of displaced women before, during, and after displacement. Programs should be tailored to prevent violence within and outside the home. Increased prevention efforts are needed in areas with high concentrations of armed men, along the contact line, and at IDP reception centers to protect displaced women. This is particularly urgent in the context of increased GBV due to COVID-19.

Improving access to frontline psychosocial services for youths in difficulty by using LSS: an action research case study

Purpose This study aims to improve accessibility to frontline psychological services for youths in difficulty. In the province of Quebec, Canada, the first significant intervention must take place within 30 days for at least 75% of the clients. Achieving this target is challenging. This was observed in the Youth Programme of a health-care network in Montreal (Centre Intégré (Universitaire) de la Santé et des Services Sociaux Centre-Sud-de-l’île-de-Montréal). Design/methodology/approach Lean Six Sigma (LSS) approach within the Action Research methodology was used. Define, Measure, Analyse, Innovate, Implement and Control structure combined with Lean techniques and a Kaizen event were implemented. Findings In total 69% of the clients have now had their first intervention within 30 days and 91% within 60 days. Improving accessibility to frontline services led to improving accessibility to second-line services. Communicating performance objectives to employees led to increasing their awareness about the importance of performance assessment and their willingness to contribute to improvement. The Kaizen event was a driving force that enabled more collaboration and trust. The participation of a partner-client in the Kaizen helped finding client-centred solutions. The large number of participants in the Kaizen added complexity. Research limitations/implications It was difficult to sort and rank a large number of solutions during the Kaizen. The impact of hiring additional employees has not been investigated. Despite the significant improvements, the targets were not achieved. More research is required to identify more accurately critical factors that have a major impact on the success of LSS projects involving complex processes. Originality/value This study contributes to the body of knowledge in Lean health care. It describes Lean tools/techniques used, solution implementation and improvements achieved in a real context. 10 success factors and 4 challenges were identified. The study provides a model for other organizations for developing their own roadmap to improve accessibility to their services, notably in large and complex processes.

Better Prevention of Femicide: Evidence from Brazil

This article presents the results of a death review study of 34 cases of femicide in the Federal District, Brazil, between 2016 and 2017. The aim of the study is to analyse how primary, secondary and tertiary prevention policies could have enhanced the prevention of these particular femicides. The study uses a mixed-method research design to analyse the judicial and health files of victims and perpetrators, supplemented by semi-structured interviews with surviving relatives. The findings highlight the need for an intersectional approach to gender, race, class and migration status in prevention policies; better risk assessment and management; enhanced women’s reporting of domestic violence earlier; and better integration of the justice system with psychosocial services. The increase of violence against women during the COVID-19 pandemic strengthens the need for an integrated approach to the prevention of lethal gender violence. This paper provides an original contribution to better comprehend the profile of femicide victims and perpetrators with a view on how to improve prevention policies in Brazil.

Caregivers Clinic at Memorial Sloan Kettering Cancer Center

The mission of the Caregivers Clinic at Memorial Sloan Kettering Cancer Center (MSK) is to assure that no caregiver of an MSK patient experiencing significant distress as a result of their caregiving responsibilities goes unidentified and deprived of necessary psychosocial services. This presentation will cover the steps taken and barriers faced in the development of the Clinic, including advocating for caregivers to receive their own unique medical records. Data regarding the number of caregivers seen for psychotherapy and for medication management will be presented, as will data regarding presenting complaints and average length of care. Also included is a discussion of the challenges faced in expanding and maintaining the capacity of the Clinic, especially in the setting of the pandemic during which caregivers' use of psychosocial care at MSK is notably higher than in years past. Several current adjunct approaches to address capacity needs currently being piloted will be discussed.

Evaluation of an electronic psycho-oncological adaptive screening program (EPAS) with immediate patient feedback: findings from a German cluster intervention study

Purpose Distress screening has become mandatory and essential in comprehensive cancer care. We evaluated an electronic psycho-oncological adaptive screening (EPAS) which assesses objective indicators of care needs and subjectively perceived care needs and subsequently provides patient feedback with individualized recommendations about psychosocial care services. Methods Patients were assessed within clusters, i.e., different oncological facilities of the competence network of the University Cancer Center Hamburg (UCCH). Patients in the intervention arm underwent the screening, controls received standard care. Patients were assessed at baseline (t0), 3-month (t1), and 6-month (t2) follow-up. Outcomes included information level and use of/access to nine psychosocial services at UCCH, well-being (GAD-7, PHQ-9, SF-8), and treatment satisfaction (SCCC). Conditional linear and logistic regressions were used to identify screening effects at t1 and t2. Results Of 1320 eligible patients across 11 clusters, 660 were included (50%). The average age was 60 years; 46% were female. The intervention was associated with increased information level for all psychosocial services at t1 and t2 (all p < .001), increased use in some of these services at t1 and t2, respectively (p ≤ .02), and better evaluation of access (e.g., more recommendations for services provided by physicians, p < .01). At t2, the intervention was associated with a lower level of satisfaction with disease-related information (p = .02). Conclusions EPAS may improve information about psychosocial services as well as utilization of and access to these services. The effect on information level seems not to be generalizable to other aspects of oncological care. Future studies should incorporate novel technologies and condense the procedure to its core factors. Implications for Cancer Survivors: The screening may help to enhance self-management competencies among cancer survivors. Trial registration The trial was retrospectively registered (2/2021) at ClinicalTrials.gov (number: NCT04749056).

Psychosocial and Patient Support Services in Comprehensive Cancer Centers

Patient support and psychosocial services are an important aspect of cancer care. Comprehensive cancer centers need to provide a spectrum of these services to provide high-quality and holistic care to cancer patients. Provision of these services begins from the time of diagnosis, continues through cancer treatment, and then subsequently transitions to survivorship or end-of-life phase. Examples of these services include psychological assessment and management, patient navigation, care coordination, genetic counseling, and complementary medicine. Survivorship care is an important aspect of patients’ experience during their cancer journey and beyond. This chapter discusses key psychosocial and supportive care services that are recommended for cancer centers that strive to provide comprehensive cancer care to their patients.

Child Sexual Abuse in South Africa: A Criminological Case Study Analysis Exploring a Life-Course-Persistent Pathway for Serial Rape and Murder

Child sexual abuse and the criminogenesis thereof are notably not perpetrated in isolation from physical and emotional abuse – although empirical evidence suggests that the most profound impact thereof revolves around a desire to escape (as a coping mechanism) into a world of deviant sexual fantasy, rape and murder. The article explores a phenomenological case study analysis of a serial rapist and murderer from birth to early adulthood, prior to incarceration – and it depicts an existence driven by fatal sadistic sexual desires, hate and lethal intent. The researchers conducted face-to-face interviews with the participant comprising of three one-hour interviews, with the aid of a semi-structured interview schedule. The study highlighted the need for a proactive response in rendering psychosocial services to the abused child.

Virtual psychosocial services for the adult population in a large community oncology practice.

283 Background: Psychological and social supports are essential to address the emotional impact of cancer. The Covid-19 pandemic exacerbated emotional distress for patients with cancer and impeded many of the traditional service delivery models for supportive services. An increase in patient reported distress from routine distress screenings highlighted the need to transition to virtual Social Work (SW) services. Methods: Patients were referred to virtual SW services three ways: self-referral, distress screenings, and clinic staff. A virtual support group registration site was created to increase awareness which was promoted by our marketing team. Three different SW facilitated virtual support groups were offered: Stronger Together, Empower Your Recovery: A Program for Healing and Growth for Living Beyond Cancer©*, and Paving the Way for Your Journey: A Cancer Support Program (PTW). Of note, the PTW six-week psychoeducation support group curriculum was developed by six employed SW facilitators. Groups included closed and open formats with scheduled frequencies. In addition to virtual support groups, standard social support including, psychosocial assessments, Advance Care Planning, virtual counseling visits were offered virtually with patients via the VSee telemedicine platform. Results: Social Work referrals increased by 154% from 949 in 2019 to 2413 in 2020 due to positive distress screening. From March 2020-21, 14,948 patients received SW services which was an increase from 10,208 seen from March 2019-20. Of these, 372 received virtual psychosocial telemedicine services from March 2020-21. There were 4092 unique webpage views to the support group information and registration website. Total number of all virtual registrants in the 3 groups from May 2020 to February 2021 was 326. Conclusions: The COVID19 pandemic required us to use, technology and virtual tools to ensure continued patient access to psychosocial services and expand access to support groups, in addition to the in-person SW services that remained. Limitations of virtual support groups and telemedicine included lack of internet access felt to be from socioeconomic barriers. Further research is needed to evaluate the benefits of providing structured psychoeducational virtual support groups to patients with cancer. Virtual counseling and support groups may continue to benefit patients with cancer.