Medical social worker is the abbreviation of medical social worker. They are professional social workers who provide psychological care and social services to patients in hospitals and medical and health institutions. Then, the following is an analysis of the emergency intervention service mode of medical social work. Welcome to read and browse.
service content
According to its own characteristics, East China Hospital mainly divides emergency into four aspects: (1) psychological and emotional problems. Research data show that when patients are troubled by diseases, they often have psychological and emotional stress. The way to deal with such problems is mainly to use the professional methods of social workers to give patients and their families appropriate psychological and emotional counseling to help them alleviate negative emotions and actively cope with the disease. (2) take care of the problem. For elderly patients who have no caregivers and cannot take care of themselves, social workers will help them complete the discharge plan and link related discharge resources, such as nursing homes, sanatoriums and rehabilitation centers. (3) Doctor-patient problem. The problem of doctors and patients has become a hot issue of widespread concern in society. The main way of treatment is to promote good communication between doctors and patients, between medical staff and their families, to clarify their respective goals and needs, and to solve problems together. (4) Economic problems. Some patients with financial difficulties, especially those from other places, can't afford expensive medical expenses and are under great economic pressure. For such problems, social workers mobilize resources inside and outside the hospital to make emergency donations to help patients reduce their economic burden.
Emergency 4C service
In the specific first-aid intervention process, the contents of first-aid services can be summarized as pre-hospital, in-hospital and post-hospital stages 16 kinds of service contents. Care: Care for patients, including family support, mutual assistance between patients and friends, volunteer visits and music care. Accompanying: Accompany patients in the process of treatment and rehabilitation, including emotional comfort, preoperative visit, rehabilitation support, environmental adaptation, etc. Counseling: provide counseling services for patients, including psychological counseling, health promotion, discharge follow-up, needs assessment, etc. Coordination: mainly refers to relationship coordination and resource coordination, including resource linking, information transmission, community service and doctor-patient harmony.
Service flow/procedure
Preparatory stage: carry out service publicity in the hospital, make emergency service cards and establish emergency case referral mechanism.
Intervention stage: after the emergency occurs, the referral person fills in the referral form, which includes the patient's basic information, referral date, referral reason, problem description, etc. Social workers make a preliminary assessment and decide whether to accept the case. If it is decided to accept the case, the social worker will formulate and implement an emergency intervention plan according to the case; If it does not meet the requirements for accepting cases, it needs to be referred to other departments or other professionals. After the referral, if necessary, social workers should follow up in time and give assistance when necessary, such as information transmission and resource linking.
Evaluation and follow-up stage: When the crisis of clients is reduced or relieved, social workers need to evaluate the process of service provision. The evaluation content is generally divided into process evaluation and result evaluation, including emergency call acceptance speed, service content pertinence, service effect, social worker service attitude, social worker communication ability, social worker professional knowledge level, overall service evaluation and service opinion.
Case description
Statement of case: Xiaoyu, female, 33 years old, married, from Shanghai, was admitted to the hospital due to head injury in a car accident. He was in a coma when he was admitted to the hospital. He was sent to the intensive care unit and transferred to the neurosurgery ward two weeks later. He was admitted to the hospital and diagnosed as head trauma, with blood clots in his brain, no fractures and other obvious injuries. Xiaoyu is an only child. Her parents and husband are both from Shanghai. She has a six-year-old daughter. Xiaoyu is currently engaged in sales industry. After the traffic accident, Xiaoyu was sent to the emergency room of our hospital and then transferred to the intensive care unit. The stress response after Xiao Yu's trauma was obvious. After brain injury treatment, he was referred to the social work department, and social workers intervened in the case.
Analysis of main problems: the client was anxious during the intensive care unit, complaining of pain accompanied by irrational beliefs? Think? There is a tumor in the brain? (excluding organic lesions and trauma)? You're going to die soon? Can't a headache be cured? And the post-traumatic stress response is obvious? Insomnia, fear, nightmare, car accident, etc.
Determine the target of intervention: (1) Establish a trusting working relationship; (2) relieving pain; (3) reduce fear and anxiety; (4) Link rehabilitation resources.
Intervention scheme
The first interview.
(1) The social worker introduced himself, told the case owner the reason for his visit, invited the case owner to describe the current situation, responded to the case owner's emotions, and made a brief psychological (emotional, cognitive, risk, mental history, etc.). ) and society (family, peers, work, socio-economic status, religious beliefs, etc. ) evaluation of the case owner. (2) Make a mutually agreed plan with the person in charge of the case on the time and frequency of the interview: twice a day (morning and afternoon) in the first week, and each interview lasts for 20 minutes; In the second week, every day 1 time, 20 minutes for each interview; After being transferred to the inpatient department, they were followed up irregularly. (3) Evaluate the objectives of the case leaders, sort the objectives, and invite the case leaders to actively participate and provide their own feedback.
Work around the goals set by the case leader.
First of all, use communication and interview skills to build trust relationships, such as active listening, emotional identification, information feedback, body language, empowerment skills and so on. Secondly, carry out pain management: (1) classify the pain, where 0 ~ 5 points represent the progress of the pain, 0 represents no pain at all, and 5 represents the most obvious pain. In each interview, the case leader scored the current overall pain and discussed the reasons for the change in the score. (2) pain record. Encourage the case owner to record the daily pain according to time, and at the same time record the activities or thoughts in each time period. Discuss the law of pain with the client in every interview, such as what the client is doing and thinking when the pain is very strong, and what is the relationship with the pain. (3) Mindfulness skills. Feel the pain area through body scanning (description of limb sensation) and relax through abdominal deep breathing. (4) Pain education. Introduce some basic pain medication methods to the case owner, and discuss with the case owner the use of painkillers and their feelings and attitudes, especially the side effects. Thirdly, how to deal with the stress: (1) Use the motivational interview skills to enhance the confidence of the clients in treatment and the motivation to change; (2) Invite the case owner to record his thoughts and emotions and discuss the relationship between them; (3) Explore irrational beliefs with the case owner through role-playing (for example, the case owner plays the therapist and the social worker plays the patient), and use exceptions and Socratic questioning methods for the case owner's absolute beliefs; (4) Pay attention to the application of systematic desensitization skills, invite the case owner to sort out the factors that cause fear, discuss the possible consequences with the case owner, and challenge his irrational beliefs when appropriate. Fourth, collect postoperative rehabilitation information for the case owner, including plastic surgery, physical rehabilitation, healthy diet and so on.
End the evaluation. After more than two weeks of continuous follow-up, Xiaoyu's pain was obviously relieved, and her anxiety and fear were also obviously improved. During hospitalization, social workers will visit Xiaoyu irregularly, communicate with medical staff and their families about other rehabilitation needs, complete the evaluation of relevant scales, and make a discharge plan.
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