The purpose of this study has been to determine, (1) whether there is a connection between a patient's social and personal background and his susceptibility to rheumatic heart disease, (2) whether emotion-producing conditions affect the development and later recurrences of this disease, (3) what the relationship is between specific social and personal pressures and the course of a rheumatic heart patient's illness, and (4) what the social worker can contribute towards alleviating these emotion-producing conditions affecting the patient's illness. Because of the limitations encountered, e.g. incomplete social histories, it has not been possible to determine the first of these. All patients (25) with rheumatic heart disease who were referred for medical social service at Shaughnessy hospital through a four-year period (1947-1951), have been selected for this study. An analysis of all available records of various branches of the department of veterans' affairs interested in the welfare of these patients, has been made. Material selected has been confined to three broad areas in the patients' lives, (1) early personality formation, (2) social and personal stress surrounding the onset, and (3) social services employed in alleviating emotional stress of patients and their families. The findings of this study indicate that an ever-increasing cycle of social problems affect the rheumatic heart patient, following the onset of his illness. Economic difficulties form the major source of emotional stress, and these in turn affect and are affected, by the earning capacity of physically-limited, chronically-diseased patients. There are indications of personality factors reacting upon the ability of the patients to accept the limitations of their illness and the demands of mature adulthood. Although this study concerns itself only with war veterans, the majority of the findings are applicable to all patients afflicted with rheumatic heart disease. Included here are, (1) the need for adequate resources, e.g. financial grants, convalescent centres, suitable housing, light employment and retraining programmes, (2) the need for more social workers as well as professionally trained social workers to insure proper use of available resources, (3) the need for more research not only with all rheumatic heart patients but with all forms of chronic illness, and (4) the need for preventive measures e.g. through education, and early diagnosis and treatment of social and personal problems. Problems resulting from increased financial grants given to veteran patients undergoing hospital care, and limitations in medical social service recording under the department of veterans' affairs, are two specific findings which are mainly applicable to the veteran. / Arts, Faculty of / Social Work, School of / Graduate

The purpose of this study is to examine the aspects of arthritis as a social welfare problem as well as a health problem, and to show (a) that the social and emotional components of the disease have a significant bearing on the "treatability" of the patient; (b) that casework, community organization and public welfare must be involved in an adequate treatment programme. The broader implications of the problem are indicated by statistics from national surveys and other related studies. But the essential material is derived from a study of cases. These include thirty hospital cases, of which twenty three were interviewed one or more times, and seven were taken from social histories in which sufficient data were available. Thirty replies were received from a special questionnaire sent to the homes of a second group of patients. The study shows that (1) each of the patients had an average of 3-1 socio-emotional problems significantly related to onset or recurrence (2) the disease created additional personal and family problems which are classified and discussed in detail, all of which prevented the patient from getting or benefiting from adequate treatment; (3) there are gaps in present treatment and rehabilitation programmes which must be filled, and (4) medical social work has an important role to play in assisting diagnosis, treatment and rehabilitation. It is hoped that this study of the social aspects of rheumatoid arthritis will clarify the role that social work must play in an adequate treatment programme, indicate the kinds of further research which would be valuable in this area and point up the need for a much broader perspective on the whole problem. / Arts, Faculty of / Social Work, School of / Graduate

In the consideration of chronic illnesses, social, emotional and economic factors are as important as the purely medical ones in determining the needs of the patients. Since hospital personnel believe that prolonged care of chronic patients in a general hospital involves a waste of hospital facilities, it would be of value to discover some of the social factors which are contributing to the prolonged hospitalization of a group of chronic disease patients. Chronic diseases were defined as those which are insidious in onset, progressive, usually long term, and from which there is never complete restoration to normal. Within this meaning of chronic illness, as arrived at through consultation, the three resident interns of the Royal Alexandra Hospital, Edmonton, selected all the chronic disease patients in the medical, surgical and children's services, on July 15, 1946. Data about these eighty patients were collected from their hospital files, through correspondence with the attending physicians, and through a case work interview, adapted to the individual situation. Long term hospitalization was arbitrarily defined as thirty days stay. According to definition forty-two of the eighty patients were long term chronic disease patients. These patients were grouped according to the type of care they required; active medical, nursing or custodial; and the data were then analysed to find what social factors were contributing to their prolonged hospitalization. The greatest single contributing factor to extension of hospitalization was the fact that twenty (fifty percent) of these patients had nowhere else to go. A combination of factors such as, no family, family unwilling, unemployment, old age, lack of early medical care and insufficient community facilities for their care, were found to be contributing to this problem. Although statistical analysis or tabulation was not found possible, grouping according to the needs of the patients was indicated in order to account for prolonged hospitalization, where an adequate medical social plan could not be arranged outside the hospital. Of the fourteen patients requiring active medical care, five were in need of a special, prolonged type of care not available elsewhere; in three cases treatment was not known; and in six instances medical care was not available until too late in the progression of the disease; due largely to the inability of these patients to pay for it. Of the thirteen patients requiring nursing care only; six lacked family facilities for care, and nursing or boarding home placements were not available; the remaining seven had homes but nursing care was not available to them because of the expense and the scarcity. Fifteen patients remained in hospital a prolonged time, though not requiring medical or skilled nursing care. Nine of these patients remained longer than three months, and two of them longer than seven years. These patients required a custodial type of care, not only for medical reasons, but because poverty made home care impossible. In six of the forty-two long term cases, hospitalization was extended because of inappropriate treatment, which was usually due to the failure of the physician to treat the patient as a whole. It was obvious throughout that there is a great need in the community for facilities for the care and treatment of the chronic sick, who do not actually require treatment in a general hospital. Perhaps more important at the present time, is the indication of the need for medical social workers to insure the use of the existing facilities in the community to the best advantage of these patients. / Arts, Faculty of / Social Work, School of / Graduate

The social problems of a group of fifty-three patients with psychogenic illness are analyzed and interpreted in this study. The patients were all those with at least one somatic complaint referred to the Social Service Department of the Royal Alexandra Hospital, Edmonton, Alberta, during the period from October 1944 to July 1946. The patients were found to have two main types of problems, those associated with their environment, and those associated with their emotional condition. The environmental problems were those associated with employment, finances, war, school, immigration, housing, and miscellaneous conditions. The emotional problems were those associated with the patients' attitude to illness, relationships with other persons, with their own emotional development; with their feelings about matters pertaining to sex; and with a number of miscellaneous feelings. In all these groups, there were forty-six different problems studied. There was a total of 550 individual problems among all the patients, with an average of 10.57 problems per patient. Of these, 126 were environmental problems, with an average of 2.7 environmental problems per patient. The average number of emotional problems per patient was 7.3, with a total of 424 such problems. There were thirteen groups of problems among the environmental and emotional problems. The most frequent problems were those associated with illness. These were found in all patients. The next most frequent group was of problems associated with the patients' relationships with others, 98.11% of the patients having problems here. 88.68% of the patients had problems associated with their emotional development. 64.15% of the patients had problems associated with employment. The same number of patients had problems arising from their attitude to matters pertaining to sex. 43.39% of the patients had problems associated with finances; 30.19%, with war; 26.41%, with school; 26.41%, with immigration; 11.32%, with housing; 41.52%, with miscellaneous situations; and 35.81%, with miscellaneous feelings. The large numbers of problems among the patients emphasizes the need for medical casework treatment for hospital patients. A brief description of the nature of medical social work and of the setting in which these problems arose, is given. Descriptive and statistical material being summarized in 9 tables. Interpretation of social work and medical terminology is given whenever the meaning of these terms appeared obscure. An example of the type of social history, from which information for this study was obtained, and a table summarizing all the problems are given in the appendices. Reading material used in the study is listed in the bibliography. / Arts, Faculty of / Social Work, School of / Graduate

Vancouver General Hospital was the first general hospital in the Province of British Columbia to establish psychiatric facilities for care of the mentally ill. The trend toward psychiatric wards and psychiatric clinics in general hospitals began during World War I because of public awareness of the need for facilities to care for mentally ill patients. In 1915, Vancouver General Hospital opened its first psychiatric ward; five years later, a psychiatric clinic was established. The aim of this study is to show what Vancouver General Hospital has contributed to psychiatric care for the mentally ill. The study is concerned with disclosing the adequacies of the hospital, as well as the inadequacies in terms of service to the patients and to the community. The information concerning the development of psychiatric facilities at Vancouver General Hospital was obtained from annual reports of Vancouver General Hospital, from the Survey of Vancouver General Hospital by the Joint Committee in 1932, and from personal interviews with the Director of Vancouver General Hospital, the Chief Staff Psychiatrist of the hospital's psychiatric department, the psychiatrist of the psychiatric ward and clinic, the hospital's first social worker, and two nurses affiliated with the first psychiatric ward and clinic. Information on the development of psychiatric facilities in the City of Vancouver was obtained by personal interviews with the head social worker of the Provincial Mental Hospital. The case material and statistical information in the study were secured from 225 records of the Social Service Department of Vancouver General Hospital. The records cover a three year period, 1947 through 1949. The number of social service records for this period totaled 450. A sample was made of every second record and 225 records were obtained. The most significant finding in the study indicates that the Psychiatric Department of Vancouver General Hospital has been handicapped in its effort to serve the mentally ill and the emotionally disturbed. The hospital is without sufficient personnel and adequate facilities to meet the demands of the community. / Arts, Faculty of / Social Work, School of / Graduate

published_or_final_version / Public Administration / Master / Master of Public Administration

Thesis (M.S.W.)--University of Hong Kong, 1993.

Thesis (M.S.W.)--University of Hong Kong, 1990. / Photocopy of typescirpt.

M.A. (Socialis Scientiae) / The gist of this extended essay is an exploration of the skills necessary to perform the planning function in management. The text is presented in two parts - a literature study and a documentation of the findings of an empirical investigation. In order to place the planning function in perspective the candidate starts by defining management as such and then discusses management in the research domain in which three specialist fields converge - management science, social work and health. Since the respondents function within the boundaries of a government setting, the influence of beaurocracy on management is included in the discussion. Subsequently all the managerial functions are described and the candidate indicates why planning is seen as the primary managerial function - it precedes all the other functions and in addition to having the status of an independent generic function, it is implicitly imbedded in the other functions. Eight categories of skills required in planning are identified: Visionary, projection, analytical, political, interactional, value-clarification, decision-making, and time-management skills. In each of these categories some abilities on the part of those who plan are indicated. The candidate then suggests a model for planning based on the literature that could be used in developing an integrated planning system for medical social workers. In the empirical part of the study the candidate attempts answering the following questions: 1. Are all the skills as mentioned in fact used by the respondents (in this case the top management section of the sub directorate of Social Work of the Branch: Health Services of the Transvaal Provincial Administration) and if they are used, how often? 2. With regard to which of these skills do respondents require extended training? Findings indicate that the respondents apply all 8 categories of skills and regard the majority of the 50 abilities as prerequisites. Learning needs were reported in respect of 13 of the abilities listed. Throughout this study the significance of the planning function in management is emphasized and the argument that managers need to develop specific knowledge and skills in order to perform effectively and efficiently is furthered.

Thesis (Ph. D.)--University of Texas at Austin, 2003. / Vita. Includes bibliographical references. Available also from UMI Company.