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Correspondence |

Social Work in Adult Critical CareSocial Work in Critical Care: A National Survey: A National Survey FREE TO VIEW

Katherine Hartman-Shea, LCSW-C; Anne P. Hahn, LCSW-C, PhD; Joanne Fritz Kraus, LCSW-C; Joyce Maygers, RN, DNP; Jonathan Sevransky, MD; Grace A. Cordts, MD
Author and Funding Information

From the Department of Social Work (Mss Hartman-Shea and Kraus and Dr Hahn) and the Department of Care Management (Dr Maygers), Johns Hopkins Bayview Medical Center; and the Department of Pulmonary and Critical Care Medicine (Dr Sevransky) and the Division of Geriatric Medicine (Dr Cordts), Johns Hopkins University.

Correspondence to: Katherine Hartman-Shea, LCSW-C, Department of Social Work, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224; e-mail: kshea1@jhmi.edu

aFive-point Likert scale: 1 = all of the time, 2 = most of the time, 3 = sometimes, 4 = occasionally, 5 = never.

Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


Chest. 2011;140(6):1670-1672. doi:10.1378/chest.11-2372
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To the Editor:

Insufficient literature exists about the role of the social worker in critical care.14 A 31-question survey to determine the interventions used most often by social workers in adult ICUs was administered to social workers in attendance at the Society for Social Work Leadership in Health Care on April 23, 2009. The survey was administered on paper and through subsequent e-mail invitations.

Survey questions were derived from a literature review1 and from the clinical experience of two critical care social workers and were independently reviewed by three critical care social workers. Responses were requested using a five-point Likert scale and text fields for demographic information. Survey questions were grouped into four categories: Team Intervention, Social Work Intervention, Patient/Family Assessment, and Patient/Family Assistance. Data were downloaded from the Web-based application and imported into a statistical software package (SPSS for Windows, version 16; SPSS Inc; Chicago, Illinois). The study protocol for the survey was conducted with the approval of the Institutional Review Board of Johns Hopkins University (ID No. NA_00026923).

A total of 86 completed surveys were received from 212 invitations (42%). Eight respondents opted out from outpatient or pediatric areas. The average age of respondents was 46.7 years, and the average number of years in practice was 20.7. Most respondents were women (85.5%), and most held a master’s degree in social work (85.5%).

The Patient/Family Assessment category was cited most frequently as part of usual social work ICU practice, with six of nine items scoring above the 80% rating of “all of the time” or “most of the time.” Assessment of social supports (97.6%), abuse/neglect (91.6%), social context of the illness (85.7%), and family’s understanding of the illness (84.7%) were the most commonly cited activities (Table 1). Patient and Family Assistance was another frequent activity, with provision of community resources (89.4%) and financial assistance (84.7%) rated all or most of the time.

Table Graphic Jump Location
Table 1 —Summary of Survey Responses

aFive-point Likert scale: 1 = all of the time, 2 = most of the time, 3 = sometimes, 4 = occasionally, 5 = never.

Facilitation of communication between the patient or family and the medical team (84.7%) was also common, with lending support with medical decision making at 78.6%, arrangement of family meetings for discharge planning at 76.8%, goals of care at 72.8%, and end-of-life interventions at 75.9%.

To our knowledge, this is the first national survey that provides information for members of the multidisciplinary team about the role of social work in critical care. Communication interventions, end-of-life care, and facilitating referrals are highly cited activities of the ICU social worker.

Hartman-Shea K, Hahn AP, Fritz Kraus J, Cordts G, Sevransky J. The role of the social worker in the adult critical care unit: a systematic review of the literature. Soc Work Health Care. 2011;502:143-157 [CrossRef] [PubMed]
 
Rose SL, Shelton W. The role of social work in the ICU: reducing family distress and facilitating end-of-life decision-making. J Soc Work End Life Palliat Care. 2006;22:3-23 [CrossRef] [PubMed]
 
McCormick AJ, Engelberg R, Curtis JR. Social workers in palliative care: assessing activities and barriers in the intensive care unit. J Palliat Med. 2007;104:929-937 [CrossRef] [PubMed]
 
Epperson MM. Families in sudden crisis: process and intervention in a critical care center. Soc Work Health Care. 1977;23:265-273 [CrossRef] [PubMed]
 

Figures

Tables

Table Graphic Jump Location
Table 1 —Summary of Survey Responses

aFive-point Likert scale: 1 = all of the time, 2 = most of the time, 3 = sometimes, 4 = occasionally, 5 = never.

References

Hartman-Shea K, Hahn AP, Fritz Kraus J, Cordts G, Sevransky J. The role of the social worker in the adult critical care unit: a systematic review of the literature. Soc Work Health Care. 2011;502:143-157 [CrossRef] [PubMed]
 
Rose SL, Shelton W. The role of social work in the ICU: reducing family distress and facilitating end-of-life decision-making. J Soc Work End Life Palliat Care. 2006;22:3-23 [CrossRef] [PubMed]
 
McCormick AJ, Engelberg R, Curtis JR. Social workers in palliative care: assessing activities and barriers in the intensive care unit. J Palliat Med. 2007;104:929-937 [CrossRef] [PubMed]
 
Epperson MM. Families in sudden crisis: process and intervention in a critical care center. Soc Work Health Care. 1977;23:265-273 [CrossRef] [PubMed]
 
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