Thesis (M.S.W.)--University of Hong Kong, 1987.

published_or_final_version / Social Service Management / Master / Master of Social Sciences

published_or_final_version / Social Work / Master / Master of Social Sciences

published_or_final_version / Public Administration / Master / Master of Public Administration

The intensity and emotional demands of the health care environment place exceptionally high performance expectations and stress on hospital social workers. Critical Incident Stress (CIS), a specific type of stress associated with dramatic, emotionally overwhelming situations, known as Critical Incidents (CIs), produce several emotional and physical reactions that can threaten the well-being of the hospital social worker. CIS, as experienced by hospital social workers, is absent from the literature and not well understood. The purpose of this study was to describe how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Lazarus and Folkman's (1984) theoretical framework of stress appraisal and coping was used to guide this descriptive study. A sample of 30 hospital social workers was recruited from two Vancouver tertiary care hospitals. Four instruments (Participant Information Sheet, Critical Incident Information Form, Emotional Appraisal Scale, and Ways of Coping Scale) were used to gain knowledge on how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Quantitative data were coded, qualitative data were subjected to content analysis, and descriptive statistics calculated. Data revealed that hospital social workers encountered CIs in their work environment and that the majority of CIs centred on death-related events. The primary traits of events appraised as CIs were novelty, suddenness, and uncertainty. Respondents reacted to the CI with a variety of emotional (anxiety, fear, frustration, worry, anger) and physical reactions (feeling overwhelmed, fatigued, withdrawn, anxious, difficulty with sleeping), and although they experienced some discomfort, these reactions were not debilitating. Most hospital social workers indicated that their personal beliefs had been challenged by the CI and revealed that they were unsure as to what their social work role or function should have been during the event. However, despite this, respondents remained confident and comfortable with the decisions they made. Hospital social workers appeared to cope well with CIs, used a variety of emotion- and problem-focused coping strategies, and reported few negative effects on their professional and/or personal lives. The top four coping strategies utilized by respondents were seeking social support, planful problemsolving, positive reappraisal, and self-control. The implications of the findings for hospital social work administration, social work training and education, hospital social work practice, and future research are discussed.

This small exploratory study considers the use of the narrative approach in eliciting and understanding illness stories. The four participants, (two male and two female) range in age from 29 years to 74 years. They live with a variety of chronic illnesses (heart disease, Multiple Sclerosis, and Pick's disease). Narrative analysis of the four semi-structured transcribed interviews revealed four dominant themes: the emotional reaction to diagnosis; the role of stress in aggravating and coping with chronic illness; a view of death; the meaning attributed to illness. / A postmodern perspective is employed to explicate the social construction of the notion of chronic illness. A critique of the medical discourse regarding chronic health challenges is offered. / This study invites social workers to consider their position of power and privilege as they learn new ways of listening to illness narratives.

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 340-375).

The intensity and emotional demands of the health care environment place exceptionally high performance expectations and stress on hospital social workers. Critical Incident Stress (CIS), a specific type of stress associated with dramatic, emotionally overwhelming situations, known as Critical Incidents (CIs), produce several emotional and physical reactions that can threaten the well-being of the hospital social worker. CIS, as experienced by hospital social workers, is absent from the literature and not well understood. The purpose of this study was to describe how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Lazarus and Folkman's (1984) theoretical framework of stress appraisal and coping was used to guide this descriptive study. A sample of 30 hospital social workers was recruited from two Vancouver tertiary care hospitals. Four instruments (Participant Information Sheet, Critical Incident Information Form, Emotional Appraisal Scale, and Ways of Coping Scale) were used to gain knowledge on how hospital social workers appraised, reacted to, and coped with CIs in their work environment. Quantitative data were coded, qualitative data were subjected to content analysis, and descriptive statistics calculated. Data revealed that hospital social workers encountered CIs in their work environment and that the majority of CIs centred on death-related events. The primary traits of events appraised as CIs were novelty, suddenness, and uncertainty. Respondents reacted to the CI with a variety of emotional (anxiety, fear, frustration, worry, anger) and physical reactions (feeling overwhelmed, fatigued, withdrawn, anxious, difficulty with sleeping), and although they experienced some discomfort, these reactions were not debilitating. Most hospital social workers indicated that their personal beliefs had been challenged by the CI and revealed that they were unsure as to what their social work role or function should have been during the event. However, despite this, respondents remained confident and comfortable with the decisions they made. Hospital social workers appeared to cope well with CIs, used a variety of emotion- and problem-focused coping strategies, and reported few negative effects on their professional and/or personal lives. The top four coping strategies utilized by respondents were seeking social support, planful problemsolving, positive reappraisal, and self-control. The implications of the findings for hospital social work administration, social work training and education, hospital social work practice, and future research are discussed. / Arts, Faculty of / Social Work, School of / Graduate

The purpose of the study was to describe the relationship between in-home health care services for elderly patients who were recently discharged from inpatient care and re-hospitalization rates. The design was descriptive and the hypothesis was that the provision of in-home health care services would mitigate a decline in the health status, of an elderly patient, following discharge from inpatient care and prevent re-hospitalization.

The intent of this research project was to discover the barriers that exist in this community when a woman attempts to access prenatal care. A concern for the well being of the children in the community and a belief in the importance of early intervention to enhance outcomes inspired the idea for this project.