Journeys into palliative care: Social workers' narratives of mobilising and sustaining practice
DOI:
https://doi.org/10.11157/anzswj-vol36iss3id1223Keywords:
palliative care, hospice, End-of-life, social work, Social work education, supportAbstract
INTRODUCTION: With Aotearoa, New Zealand's increasing diversity and ageing population, social work has a vital role in palliative care practice. This study advances the understanding of palliative care social work and its implications for practice, education and support from a practitioners’ point of view.
METHODS: Utilising a constructivist case study approach, in-depth data was collected from social work practitioners about their pathways and practices in palliative care. Purposive and snowball sampling techniques were employed, resulting in 12 individual semi-structured interviews and a focus group with 5 participants.
FINDINGS: The participants' voices illustrate current social work practice and its implications from personal, pedagogical, and professional perspectives. Participants were often drawn to palliative care social work through career embeddedness and personal experiences of loss and grief. The study revealed how past, present, and future considerations shape palliative social work practice, including journeys to palliative care, mobilising social work practice, and sustaining support. Participants used various assessment tools based on service context, with limited exposure to palliative care in tertiary curricula. Most participants continued to seek post-qualifying professional development opportunities working in this field.
CONCLUSION: The study underscores the importance of team support, ongoing education, and self-care for effective social work practice in palliative care. Recommendations include enhancing educational emphasis on palliative care, developing a New Zealand-based assessment tool for palliative care social work, and improving professional encounters related to death and dying. These insights can guide efforts to enhance palliative care social work practice in Aotearoa, New Zealand.
References
Ballantyne, N., Beddoe, L., Hay, K., Maidment, J., Walker, S., & Mayhew, Z. (2019). Enhancing the readiness to practise of newly qualified social workers in Aotearoa, New Zealand (Enhance R2P)—Report on phase two: The readiness to practise of NQSWs. Wellington, NZ: Ako Aotearoa.
Barbour, R. S., & Kitzinger, J. (Eds.). (1999). Developing focus group research: Politics, theory and practice. Sage Publications. https://doi.org/10.4135/9781849208857
Bloomquist, K. R., Wood, L., Friedmeyer-Trainor, K., & Kim, H. (2016). Self-care and professional quality of life: Predictive factors among MSW practitioners.
Advances in Social Work, 16(2), 292–311. https://doi.org/10.18060/18760
Cagle, J. G., Osteen, P., Sacco, P., & Jacobson Frey, J. (2017). Psychosocial assessment by hospice social workers: A content review of instruments from a national sample. Journal of Pain and Symptom Management, 53(1), 40–48. https://doi.org/10.1016/j.
jpainsymman.2016.08.016
Davies, E., & Higginson, I. J. (Eds.). (2004). Better palliative care for older people. World Health Organisation. https://www.euro.who.int/data/assets/pdf_file/0009/98235/E82933.pdf
Dewane, C. (2006). Use of self: A primer revisited. Clinical Social Work Journal, 34(4), 543–558. https://doi.org/10.1007/s10615-005-0021-5
Doka, K. (2002). Disenfranchised grief: new directions, challenges and strategies for practice. Research Press.
Doody, O., & Noonan, M. (2013). Preparing and conducting interviews to collect data. Nurse Researcher, 20, 28–32.
https://doi.org/10.7748/nr2013.05.20.5.28.e327
Durie, M. (1994). Whaiora: Māori health development. Oxford University Press.
Figley, C. R. (Ed.). (1995) Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
Gettinger, T. (2020). Palliative care: A guide for health social workers. Journal of Gerontological Social Work, 63(4), 374–376. https://doi.org/10.1080/01634372.2019.1689214
Head, B., Peters, B., Middleton, A., Friedman, C., & Guman, N. (2019). Results of a nationwide hospice and palliative care social work job analysis. Journal of Social Work in End-of-Life & Palliative Care, 15(1), 16-33. https://doi.org/10.1080/15524256.2019.1577326
Hospice New Zealand. (2023). Te Ara Whakapiri: Principles and guidance for the last days of life. https://www.hospice.org.nz/resources/te-ara-whakapiri-principles-and-guidance-for-the-last-days-of-life/
Hospice New Zealand. (2024). We’re here when you need us. https://www.hospice.org.nz/
Fordham, P., & Howell, S. (2012). Effects of a psychosocial assessment tool on interdisciplinary team utilization in a palliative care unit (784). Journal of Pain and Symptom Management, 43, 470-471.
Islam, M. R. (2024). Introduction to social work. In Fieldwork in social work. Springer. https://doi.org/10.1007/978-3-031-56683-7_1
Jacob, S. A., & Furgerson, S. P. (2012). Writing interview protocols and conducting interviews: Tips for students new to the field of qualitative research. The Qualitative Report, 17(42), 1–10. https://nsuworks.nova.edu/tqr/vol17/iss42/3/
Kaushik, A. (2017). Use of self: A primer revisited. Clinical Social Work Journal, 34(4), 543–558. https://doi.org/10.1007/s10615-005-0021-5
Lawson, R. (2007). Home and hospital; hospice and palliative care: How the environment impacts the social work role. Journal of Social Work in End-of-Life & Palliative Care, 3(2), 3–17. https://doi.org/10.1300/J457v03n02_02
Lee, J. J., & Miller, S. E. (2013). A self-care framework for social workers: Building a strong foundation for practice. Families in Society, 94(2), 96–103. https://doi.org/10.1606/1044-3894.4289
MacLeod, R., & Macfarlane, S. (2019). The palliative care handbook (9th ed.). https://www.waipunahospice.org.nz/wp-content/uploads/2019/04/Palliative-Care-Handbook-2018.pdf
Mills, J., Wand, T., & Fraser, J. A. (2018). Exploring the meaning and practice of self-care among palliative care nurses and doctors: A qualitative study. BMC Palliative Care, 17, 63. https://doi.org/10.1186/s12904-018-0318-0
Ministry of Health NZ. (2017, September 7). Te Ara Whakapiri: Principles and guidance for the last days of life. https://www.health.govt.nz/publication/te-ara-whakapiri-principles-and-guidance-last-days-life
Ministry of Health NZ. (2018). Palliative care action plan. https://www.health.govt.nz/system/files/documents/publications/palliative-care-action-plan_0.pdf
Mino, J., & Lert, F. (2005). Beyond the biomedical model: Palliative care and its holistic model. HEC Forum, 17, 227–236. https://doi.org/10.1007/s10730-005-2549-8
Palcare. (2024). About us. http://www.palcare.com.au/index.php/about/
Paul, S. (2016). The role of social workers in palliative, end-of-life and bereavement care. Psychosomatics, 42(3), 241–246. https://doi.org/10.1176/appi.psy.42.3.241
Reese, D. J. (2011). Interdisciplinary perceptions of the social work role in hospice: Building upon the classic Kulys and Davis study. Journal of Social Work in End-of-Life & Palliative Care, 7(4), 383–406. https://doi.org/10.1080/15524256.2011.6234747
Reese, D. J., & Csikai, E. L. (2018). Social work assessment and outcomes measurement in hospice and palliative care. American Journal of Hospice and Palliative Medicine®, 35(12), 1553–1564. https://doi.org/10.1177/1049909118788342
Rose, S., & Palattiyil, G. (2020). Surviving or thriving? Enhancing the emotional resilience of social workers in their organisational settings. Journal of Social Work, 20(1), 23– 42. https://doi.org/10.1177/1468017318793614
Rubin, A., & Babbie, E. R. (2010). Research methods for social work. Cengage Learning.
Saldaña, J. (2015). The coding manual for qualitative researchers (3rd ed.). SAGE.
Sansó, N., Galiana, L., Oliver, A., Pascual, A., Sinclair, S., & Benito, E. (2015). Palliative care professionals’ inner life: Exploring the relationships among awareness, self-care, and compassion satisfaction and fatigue, burnout, and coping with death. Journal of Pain and Symptom Management, 50(2), 200–207. https://doi.org/10.1016/j.jpainsymman.2015.02.013
Saunders, C. (1993). Foreword. In D. Doyle, G. Hanks, & N. Macdonald (Eds.), Oxford textbook of palliative medicine (pp. v–viii). Oxford Medical Publications.
Saunders, C. (2001a). The evolution of palliative care. Journal of the Royal Society of Medicine, 94(9), 430–432. https://doi.org/10.1177/014107680109400904
Saunders, D. C. (2001b). Social work and palliative care—The early history. The British Journal of Social Work, 31(5), 791–799. http://www.jstor.org/stable/23716352
Simpson, J. (2013). Grief and loss: A social work perspective. Journal of Loss and Trauma, 18(1), 81–90. https://doi.org/10.1080/15325024.2012.684569
Stake, R. E. (1995). The art of case study research. SAGE Publications.
Stake, R. E. (2008). Qualitative case studies. In N. K. Denzin & Y. S. Lincoln (Eds.), Strategies of qualitative inquiry (pp. 119–149).: Sage Publications.
Stake, R. E. (2010). Qualitative research: Studying how things work. Guilford Press.
Stats NZ. (2023). Births and deaths: Year ended December 2023 (including abridged period life table). https://www.stats.govt.nz/information-releases/births-and-deaths-year-ended-december-2023-including-abridged-period-
life-table
Stein, G. L., Cagle, J. G., & Christ, G. H. (2017). Social work involvement in advance care planning: Findings from a large survey of social workers in hospice and palliative care settings. Journal of Palliative Medicine, 20, 253–259. https://doi.org/10.1089/jpm.2016.0310
Taels, B., Hermans, K., Van Audenhove, C., Boesten, N., Cohen, J., Hermans, K.,& Declercq, A. (2021). How can social workers be meaningfully involved in palliative care? A scoping review on the prerequisites and how they can be realised in practice. Palliative Care and Social Practice, 15. https://doi.org/10.1177/26323524211058895
Thornton, G. (2010). Aged residential care service review. Auckland New Zealand. Retrieved from https://www.grantthornton.co.nz/globalassets/1.-member-firms/newzealand/pdfs/aged-residential-care-service-review-summary.pdf
Walsh, J. (2021). The use of self. In The dynamics of the social worker-client relationship (online ed.). Oxford Academic. https://doi.org/10.1093/oso/9780197517956.003.0004
World Health Organisation. (2020, August 5). Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Aotearoa New Zealand Association of Social Workers
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
By completing the online submission process, you confirm you accept this agreement. The following is the entire agreement between you and the Aotearoa New Zealand Association of Social Workers (ANZASW) and it may be modified only in writing.
You and any co-authors
If you are completing this agreement on behalf of co-authors, you confirm that you are acting on their behalf with their knowledge.
First publication
By submitting the work you are:
- granting the ANZASW the right of first publication of this work;
- confirming that the work is original; and
- confirming that the work has not been published in any other form.
Once published, you are free to use the final, accepted version in any way, as outlined below under Copyright.
Copyright
You assign copyright in the final, accepted version of your article to the ANZASW. You and any co-authors of the article retain the right to be identified as authors of the work.
The ANZASW will publish the final, accepted manuscript under a Creative Commons Attribution licence (CC BY 4.0). This licence allows anyone – including you – to share, copy, distribute, transmit, adapt and make commercial use of the work without needing additional permission, provided appropriate attribution is made to the original author or source.
A human-readable summary of the licence is available from http://creativecommons.org/licenses/by/4.0, which includes a link to the full licence text.
Under this licence you can use the final, published version of the article freely – such as depositing a copy in your institutional research repository, uploading a copy to your profile on an academic networking site or including it in a different publication, such as a collection of articles on a topic or in conference proceedings – provided that original publication in Aotearoa New Zealand Social Work is acknowledged.
This agreement has no effect on any pre-publication versions or elements, which remain entirely yours, and to which we claim no right.
Reviewers hold copyright in their own comments and should not be further copied in any way without their permission.
The copyright of others
If your article includes the copyright material of others (e.g. graphs, diagrams etc.), you confirm that your use either:
- falls within the limits of fair dealing for the purposes of criticism and review or fair use; OR
- that you have gained permission from the rights holder for publication in an open access journal.