Abstract

Background: Throughout history, the field of medical social work has been shaped by epidemics and pandemics. As COVID-19 rapidly overwhelmed the healthcare system in 2020, oncology departments found that space, staff, and funds were reallocated to address patient needs during the pandemic. Traditional outpatient services were required to operate with reduced resources, with special attention to additional measures to protect workers and patients from exposure to the virus. Little is known about how these changes affected the nature of the practice of oncology social work.

Methods: We compared data on OSW interventions for three months (March-May) 2019 to the same period in 2020. Mount Sinai Downtown Cancer Center’s Department of Social Work routinely collects data on services provided by social workers using a validated instrument. As NYC became the epicenter of the COVID-19 in March 2020, the comparison of these time periods creates a natural experiment to examine whether and how the presence of the virus impacted the services provided by OSWs.

Findings: There was little difference in the number of encounters that took place between the two time periods (2186 encounters in 2019 and 2084 encounters in 2020); however, there were notable differences in the types of interventions. While interventions involving supportive counseling decreased in 2020, we identified a significant increase specific to bereavement counseling.

Conclusion: The study shows a remarkable consistency in the volume and types of services provided by OSWs, in spite of the radical increase in stressors they experienced during the height of the COVID-19 pandemic. These findings suggest that the OSWs did not allow these stressors to interfere with their work with patients. This study demonstrates how routine use of an instrument to measure OSW interventions can be used to examine services provided over time and to evaluate potential influences of external factors.

摘要

背景：纵观历史，医学社会工作领域一直受到流行病和大流行病的影响。由于 COVID-19 在 2020 年迅速淹没了医疗保健系统，肿瘤科发现在大流行期间重新分配了空间、人员和资金以满足患者的需求。传统的门诊服务需要在资源减少的情况下运作，并特别注意采取额外措施来保护工人和患者免于接触病毒。关于这些变化如何影响肿瘤学社会工作实践的性质知之甚少。

方法：我们将 2019 年三个月（3 月至 5 月）的 OSW 干预数据与 2020 年同期进行了比较。西奈山市中心癌症中心的社会工作部门使用经过验证的工具定期收集社会工作者提供的服务的数据。随着纽约市于 2020 年 3 月成为 COVID-19 的震中，这些时间段的比较创造了一个自然实验，以检查病毒的存在是否以及如何影响 OSW 提供的服务。

调查结果：两个时间段之间的遭遇次数几乎没有差异（2019 年为 2186 次，2020 年为 2084 次）；然而，干预类型存在显着差异。虽然涉及支持性咨询的干预措施在 2020 年有所减少，但我们发现特定于丧亲咨询的干预措施显着增加。

结论：该研究表明，尽管在 COVID-19 大流行期间他们经历的压力源急剧增加，但 OSW 提供的服务的数量和类型具有显着的一致性。这些发现表明 OSW 不允许这些压力因素干扰他们与患者的工作。本研究展示了如何通过常规使用测量 OSW 干预的工具来检查随时间提供的服务并评估外部因素的潜在影响。