Abstract

Social workers play an integral role in end-of-life planning and patient outcomes, and yet how social workers approach such conversations with patients is not well understood. The current study employed a cross-sectional design to examine social worker planned communication about end-of-life care using a multiple goals framework. Recruited from online listservs, a content analysis was conducted with social worker curated plans (n = 20) for end-of-life conversations. Plans were coded for topics and content alignment with instrumental, identity, and relational goal types. Topics found were related to eliciting patient goals and the utilization of written resources. A substantial percentage of social workers also noted the inclusion of other parties in the conversation. Findings suggested that content was predominately instrumental (i.e. task-oriented) with an overwhelming majority adhering to multiple conversational goals. Plan content affords insight to occupational orientation and prioritization during conversations with patients. Further, identifying how the majority of planned responses integrate multiple goals simultaneously gives credence to existing research regarding enhanced conversational effectiveness when social workers are present on the palliative care team.

摘要

社会工作者在临终计划和患者结果方面发挥着不可或缺的作用，但社会工作者如何与患者进行此类对话尚不清楚。当前的研究采用横断面设计，以使用多目标框架检查社会工作者计划的关于临终关怀的交流。从在线列表服务中招募，使用社会工作者策划的计划进行内容分析（n = 20) 用于生命终结对话。计划针对主题和内容与工具、身份和关系目标类型保持一致进行编码。发现的主题与引发患者目标和书面资源的利用有关。相当大比例的社会工作者还注意到对话中包含了其他各方。调查结果表明，内容主要是工具性的（即面向任务的），绝大多数都坚持多个对话目标。计划内容在与患者对话期间提供对职业定位和优先级的洞察。此外，确定大多数计划的响应如何同时整合多个目标，使现有的关于当社会工作者出现在姑息治疗团队时提高对话效率的研究具有可信度。