Patients referred from a multidisciplinary pain clinic to the social worker, their socio-demographic profile and the contribution of the social worker to the management of the patients

Scandinavian Journal of Pain - Tập 1 - Trang 213-219 - 2010
Heli Aho1, Timo Kauppila2, Maija Haanpää3
1Pain Clinic, Department of Anaesthesia and Intensive Care Medicine and Department of Neurology, Helsinki University Central Hospital, Finland
2Network of Academic Health Centers, University Hospital of Helsinki, Unit of General Practice, Department of Public Health, University Helsinki, Korso Social and Health Centre, City of Vantaa, Finland
3Etera Mutual Pension Insurance Company and Rehabilitation ORTON, Helsinki, Finland

Tóm tắt

Abstract Background and aims Social factors and social environment shape the pain behavior of patients. Social workers support pain treatment in a multidisciplinary pain clinic by altering the social environment of a patient. Even though a social worker in a multi-professional care team contributes to the care of select, severely pain-afflicted patients extensively, neither the patient socio-demographic status nor interventions by social workers have been systematically documented. Only individual case histories have been published. Developing social work activities, which have potential financial consequences, for example, requires charting the current situation prior to systematic research into the efficacy of individual social work interventions. Methods This study systematically details the performance and work volume of the social worker, as well as the socio-demographics of patients during a 16-month period in a multidisciplinary pain clinic of a university hospital. Results Fifty-five patients were included. Twenty-nine were women and 26 men. They were about 10% of all patients seen at the pain clinic during the same time. Most of the patients were at their middle age. The largest group of subjects worked in public or other services. The second largest group consisted of those working in stores, hotels and restaurants. Over half of the subjects worked in the service industry. Since the subjects had scant vocational education, they worked mainly in manual labor. Most of the patients had problems with making a living, signifying that a major number of the patients visited the social worker because of financial problems. About half of the patients were indebt and three were undergoing debt counseling. Of homeowners, 21% were indebt, while the portion of those living rented accommodation was almost two thirds. All patients seen by the social worker received some form of public assistance. Over half of the patients had participated in rehabilitation assessment. The social worker saw 39 patients once, one patient twice and 15 patients three or more times. The duration of a visit was typically 1–2 h. The issues of a patient are addressed by contacting authorities and negotiating with other health care staff. According to the used ‘SOSU’ classification data, the social situation was charted for 49 patients, while the benefits and assistance provided by the Social Insurance Institution of Finland was discussed with half of the patients. The social worker discussed employment based pension with about a third of the patients. Social assistance, the last-resort economic assistance under social welfare, was considered with one fifth of the patients. Psychosocial work was recorded for 19 patients, comprising longer-term, supportive discussion. Conclusions The majority of the patients is of active working age but their working capacity is often decreased. However, they have difficulties in getting compensation for reduced ability to making a living. Hence, they have economic difficulties of various types and need counselling and support. The main duty of the social worker appeared to be advising the patient in using the social welfare system, as the clients turned out to constitute a marginalized group.

Tài liệu tham khảo

Bates MS, Rankin-Hill L, Sanchez-Ayendez M, Mendez-Bryan R. Across-cultural comparison of adaptation to chronic pain among Anglo-Americans and native Puerto Ricans. Med Anthropol 1995;16:141–73. Valat JP, Goupille P, Védere V. Low back pain: risk factors for chronicity. Rev Rheum Engl Ed 1997;64:189–94. Poleshuck EL, Green CR. Socioeconomic disadvantage and pain. Pain 2008;136:235–8. Subramanian K, Rose SD. Social work and the treatment of chronic pain. Health Soc Work 1988;13:49–60. MacDonald JE. A deconstructive turn in chronic pain treatment: a refined role for social work. Health Soc Work 2000;25:51–8. ISWF General meeting. Definitation of social work. http://www.ifsw.org./publications/4.6.pub.html [23.7.03]. Spiler M. Social work practice with chronic pain management. In: Holosko MJ, Taylor PA, editors. Social work practice in health care settings. Toronto: Canadian Scholars Press; 1994. p. 453–66. Coyle GS. Family therapy with a pain patient: rehabilitation hospital. In: Kerson TS, editor. Social work in health settings: practice in context. Binghamton: The Haworth Press; 1997. p. 335–52. Holloway I, Soafer B, Walker J. The transition from well person to “pain afflicted” patient: the career of people with chronic back pain. Illn Crisis Loss 2000;8:373–87. Sieppert JD. Attitudes toward and knowledge of chronic pain: a survey of medical social workers. Health Soc Work 1996;21:122–9. Http://www.stat.fi/tk/tt/luokitukset/opas.html [2.1.01]. Goldberg RJ, Wallace S, Rothney J, Wartman S. Medical clinic referrals to psychiatric social work review of 100 cases. Gen Hosp Psychiatry 1984;6:147–52. Lamminpää K, Mattila P.Toimeentulotuki 2000. [Living allowance 2000]. Helsinki: Sosiaali-ja terveysalan tutkimus-ja kehittämiskeskus; 2001. Jamison RN, Virts KL. The influence of family support on chronic pain. Behav Res Ther 1990;28:283–7. Gil KM, Keefe FJ, Crisson JE, Van Dalfsen PJ. Social support and pain behavior. Pain 1987;29:209–17. Flor H, Turk DC, Scholz OB. Impact of chronic pain on the spouse: marital, emotional and physical consequences. J Psychosom Res 1987;31:63–71. Kontula O, Viinamäki H, Koskela K. Köyhiä ja Kipeitä. [Poors and sicks]. Helsinki: Väestöliitto Väestöntutkimuslaitos Julkaisusarja D 33; 1998. Lahdelma E. Terveydentila ja sosiaalinen rakenne. [Health status and social construction]. In: Kangas I, Karvonen S, Lillrank A, editors. Terveyssosiologian suuntauksia. [Trends in health Sociology]. Helsinki: Gaudeamus; 2000. Grossi G, Soares JJ, Angesleva J, Perski A. Psychosocial correlates of long-term sick-leave among patients with musculoskeletal pain. Pain 1999;80:607–19. Halonen U. Säästäminen ja luotonkäyttö. [Saving and the use of credit]. Helsinki: Suomen Pankkiyhdistys; 2003. Raunio K. Sosiaalityö murroksessa. [Social work in change]. Helsinki: Gaudeamus; 2000. Fields HL, editor. Core curriculum for professional education pain. Seattle: IASP Press; 1995.
Thông tin
Thông tin xuất bản

Scandinavian Journal of Pain

Tập 1

213-219

Thông tin tác giả