End-of-Life Care and Family : Service Provision and Roles of Clinical Social Workers

Abstract

The study on the End-of-Life Care and Family: Service Provision and Roles of Clinical Social Workers aimed to study the caring service patterns provided for the end-of-life patients in the hospitals. It also investigated the roles of clinical social workers on providing the care for the end-of-life patients. The mixed methods were used in this research; namely, the quantitative method was principally used and additionally supplemented with the qualitative data. The questionnaires were distributed to the social workers or social work practitioners providing the palliative care for the end-of-life patients and families in 131 government hospitals nationwide. Eighty questionnaires (61.06%) were returned accordingly. The in-depth interviews of four social workers having the experience on providing the care to the end-of-life patients for at least three years were regarded as the supplemented data for this research.

The quantitative study results revealed that most of the respondents were female. It was further found out that 91.3% of them aged 41-50 years old; 35.7% obtained the bachelor’s degree with the social work program; 36.0% worked under the regional hospitals (general hospitals); 48.8% had the average experience on providing the care to the end-of-life patients for 5.5 years (minimum = < 1 year, maximum = 26 years) whereas 68.8% of the respondents were never been trained on providing the palliative care for the end-of-life patients. In regard with the patterns of social work services, it was found that in the fact-finding step, 96.9% of the social workers mostly interviewed the end-of-life patients and families. In contrary, the pattern of service least provided by the social workers was involved with the intervention i.e. only 18.8% held the activities of art therapy for the end-of-life patients and families. For the role on providing the direct services of the social workers, 90% of the role was involved with the coordination of social resources with and the protection of rights provided for the end-of-life patients and families. Regarding the role on providing the indirect services, 17% of the role was involved with the orientation and practices related to the palliative care provided for the end-of-life patients and families.

The results of qualitative study, the role of social workers on providing the palliative care for the end-of-life patients and families was diverse. The body knowledge applied in the social work practices included the concepts of holistic care, humanism, religious belief, and also the respect of humanization and dignity based on the client-centered care. The important techniques or skills involved were mainly the professional relationship, communication and consulting skills, family therapy, and truth telling technique provided for the end-of-life patients and/or families.