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Older adults are at a digital disadvantage because of social stereotypes and a lack of social support; however, smartphones have become a necessary technology to cope with crises and daily life in China, especially during the pandemic. This study aimed to help marginalized older adults take on new tasks by developing digital technology education that used a framework of social cognitive theory in social work. The study followed a quasi-experimental design in which 153 elderly people were recruited from three community service centers; 90 of the participants received 6-weekly intervention. Intent-to-treat analysis, effect size calculations, and sensitivity analysis were conducted. The findings show that digital education significantly enhanced two domains of digital life adaptation abilities: general digital life adaptation abilities [g = .50, 95% CI (.70, 2.69)] and pandemic digital life adaptation abilities [g = .89, 95% CI (.96, 2.07)]. The intervention also improved three domains of digital self-efficacy: sharing and communication [g = .55, 95% CI (.04, .48)], verification [g = .34, 95% CI (.01, .59)], and influencing others [g = .53, 95% CI (.13, .77)]. The study showed that the new intervention approach reduced the harm to vulnerable older adults in the digital wave, especially during the pandemic.

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Purpose: Support implementation fidelity in intervention research with lesbian, gay, bisexual, transgender, queer, and sexual and gender diverse (LGBTQ+) populations, this study explores the systematic development of a fidelity process for AFFIRM, an evidence-based, affirmative cognitive behavioral therapy group intervention for LGBTQ+ youth and adults. Method: As part of a clinical trial, the AFFIRM fidelity checklist was designed to assess clinician adherence. A total of 151 audio-recorded group sessions were coded by four trained raters. Results: Adherence was high with a mean fidelity score of 84.13 (SD = 12.50). Inter-rater reliability was 81%, suggesting substantial agreement. Qualitative thematic analysis of low-rated sessions identified deviations from the manual and difficulties in group facilitation, while high-rated sessions specified affirmative and effective clinical responses. Discussion: Findings were integrated into clinical training and coaching. The fidelity process provides insights into the challenges of implementing social work interventions effectively with LGBTQ+ populations in community settings.

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In 2020, the COVID-19 pandemic thrust the world's population into a crisis. Social workers and other professionals working with youth have been front-line witnesses to the accentuated negative impact of this public health emergency on youth and their families as well as to the creative adaptive strategies of youth and their families. Purpose: Because youth workers are often the first to identify and respond to the needs and desires of children and youth, it is critical to better understand the ways in which youth workers adapted, coped, and intervened within the context of this global health, social, and economic crisis. Youth workers play a central role in the lives of children and youth. Their perspective is key to recognizing both practice innovation and organizational impediments. Method: 31 youth workers in mental health, housing, primary care, and child protection participated in focus groups discussing the impact of the pandemic during waves 1 and 2 on the youth and families they work with and, consequently, on their own practice. Results: include two central domains that organize findings around adapting professional practice to crisis situations: (1) the first-person experience of working with youth during the pandemic; (2) the changing needs and risks faced by youth and their families. Discussion: These domains include discussions around participant emotions and feelings of isolation, helplessness, and fear as well as adaptability. The article concludes with recommendations to support youth workers and adapt organizational structures to help protect youth from increased risk and vulnerability during a pandemic or other crises.

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Background: Several studies have examined the occupational factors associated with alcohol use and dependence. However, there are very few studies that investigated the role of occupational factors associated with long-term abstinence among persons treated for alcohol dependence in India. Aim: To examine the occupational factors associated with long-term abstinence among persons treated for alcohol dependence. Methods: Sixty in-patients treated for alcohol dependence were selected using inclusion criteria from the Government-run de-addiction center, tertiary care teaching hospital, Bangalore. All patients were followed up periodically for 1 year. The semi-structured interview schedule was used for collecting data on occupational factors associated with long-term abstinence. Descriptive statistics, Chi-square test, and Fisher exact test were used for data analysis. Results: There was a positive trend showing self-employed (pf = 1.74, P = 0.45), having skilled work (pf = 1.52, P = 0.72), regular pattern of employment (pf = 1.21, P =.60), monthly mode of income (pf = 1.43, P =.76) were factors associated with abstinence. Among eight occupational variables, employment status (x 2 = 4.0, P =.04) and having well-defined working hours ((pf = 6.18, P =.04) were significantly associated with long-term abstinence among persons treated for alcohol dependence. Conclusion: Occupational factors seem to influence the outcome in alcohol dependence and appropriate vocational interventions would be effective in promoting long-term abstinence.

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PURPOSE: To support future development and refinement of social work-led intervention programs among patients with firearm injuries and to demonstrate how a fidelity assessment can be used to adjust and refine intervention delivery in an ongoing trial. METHODS: We conducted a fidelity assessment of a randomized controlled trial of a social work-led intervention among patients with a firearm injury. RESULTS: We found that our study intervention was well implemented, meeting 70% of the fidelity assessment score items, however noted lower fidelity with client-based items. DISCUSSION: As a result of fidelity assessment findings, we refined intervention delivery to improve implementation fidelity including beginning to review cases of all patients each month, rather than focusing on patients in crisis. Our fidelity assessment process and findings offer insight into the challenges of implementing an intervention among patients with firearm injuries and highlights the value of monitoring intervention fidelity during an ongoing trial.

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BACKGROUND: Few studies have specifically addressed quality of life issues for elderly hospice patients. The purpose of this study is to explore various factors and service patterns of the quality of life of end-of-life care for the elderly. METHODS: We collect the data and make small-scale exploratory study via semi-structured individual interviews. Data were collected from the family of 2 elderly cancer patients receiving hospice services, and the data were analyzed qualitatively. RESULTS: After investigation, we found that elderly people in hospice care, regardless of age, are suffering from physical and psychological pain and do not want to spend the rest of their lives in the hospital, but want to die in their own homes. CONCLUSIONS: Both hospitalization and in-home care can improve resource utilization, and the key is to find various factors affecting the quality of life. Improving the quality of life is what patients and their families need most.

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BACKGROUND: Disruptive behavior in hospitalized patients has become a priority area of safety concern for clinical staff, and also has consequences for patient management and hospital course. Proactive screening and intervention of patients with behavioral comorbidities has been reported to reduce disruptive behavior in some settings, but it has not been studied in a rigorous way. METHODS: The Disruptive bEhavior manageMEnt ANd prevention in hospitalized patients using a behaviORal intervention team (DEMEANOR) study is a pragmatic, cluster, crossover trial that is being conducted. Each month, the behavioral intervention team, comprising a psychiatric-mental health advanced practice nurse and a clinical social worker, with psychiatrist consultation as needed, rotates between an adult medicine unit and a mixed cardiac unit at Vanderbilt University Medical Center in Nashville, TN, USA. The team proactively screens patients upon admission, utilizing a protocol which includes a comprehensive chart review and, if indicated, a brief interview, seeking to identify those patients who possess risk factors indicative of either a potential psychological barrier to their own clinical progress or a potential risk for exhibiting disruptive, aggressive, or self-injurious behavior during their hospitalization. Once identified, the team provides interventions aimed at mitigating these risks, educates and supports the patient care teams (nurses, physicians, and others), and assists non-psychiatric staff in the management of patients who require behavioral healthcare. Patients who are both admitted to and discharged from either unit are included in the study. Anticipated enrollment is approximately 1790 patients. The two primary outcomes are (1) a composite of objective measures related to the patients' disruptive, threatening, or acting out behaviors, and (2) staff self-reported comfort with and confidence in their ability to manage patients exhibiting disruptive, threatening, or acting out behavior. Secondary outcomes include patient length of stay, patient attendant (sitter) use, and the unit nursing staff retention. DISCUSSION: This ongoing trial will provide evidence on the real-world effectiveness of a proactive behavioral intervention to prevent disruptive, threatening, or acting out events in adult hospitalized patients. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03777241. Registered on 14 December 2018.

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BACKGROUND@#Few studies have specifically addressed quality of life issues for elderly hospice patients. The purpose of this study is to explore various factors and service patterns of the quality of life of end-of-life care for the elderly.@*METHODS@#We collect the data and make small-scale exploratory study via semi-structured individual interviews. Data were collected from the family of 2 elderly cancer patients receiving hospice services, and the data were analyzed qualitatively.@*RESULTS@#After investigation, we found that elderly people in hospice care, regardless of age, are suffering from physical and psychological pain and do not want to spend the rest of their lives in the hospital, but want to die in their own homes.@*CONCLUSIONS@#Both hospitalization and in-home care can improve resource utilization, and the key is to find various factors affecting the quality of life. Improving the quality of life is what patients and their families need most.

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Often referred to as miscarriage, Early Pregnancy Loss (EPL) is the spontaneous death of a fetus experienced within the first 20 weeks of gestation and is the most common complication in pregnancy. Symptoms of an impending EPL are routinely managed in the Emergency Department (ED). EPL can have a substantial impact on women, potentially leading to psychological and emotional health issues and risks to future pregnancies. Despite the high prevalence of EPL, many women suffer in silence due to the common societal belief that EPL are insignificant. Many women experience EPL as an ambiguous loss and are at risk for disenfranchised grief. Compassionate, patient-centred care has been identified by women as an essential and often missing aspect of ED care and can have a profound impact on the overall well-being of women after EPL. Social workers play a critical role in the ED given that they prioritize the psychosocial well-being of patients in a system that is structured to primarily address trauma care. In an effort to reduce the psychological impact and complicated grief reactions of women experiencing EPL, specific recommendations for social work intervention to address the individual needs of women experiencing EPL in the ED are presented. These include acknowledging the loss, providing psychoeducation, honouring the loss, assessing resources, referral and additional information, and building capacity in the ED.

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During the long treatment period (from the treatment of early stage to rehabilitation), burn patients have experienced many problems that they cannot handle it. It is very important as to overcome psychosocial problems of burn patient as to get treatment. The social work intervention for burn patients is so necessary for psychosocial problems solving; this intervention require to support by family. Depending on burn treatment procedure, and patient's social status, each burn patients have different symptom of psychosocial problems. Medical social workers work through different method of intervention that included casework, group work, connecting community resource and etc.

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