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Patient-centered approach to building problem solving skills among older primary care patients: problems identified and resolved
- Authors:
- ENGUIDANOS Susan, et al
- Journal article citation:
- Journal of Gerontological Social Work, 54(3), April 2011, pp.276-291.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Problem Solving Therapy (PST) teaches patients to address their life difficulties by reducing problems into smaller sections and identifying specific steps towards making positive change. This article describes the problems identified by older primary care patients enrolled in PST, and explores factors associated with successful problem resolution. The participants were 107 patients aged 65 years and more with 2 or more chronic conditions and at least one emergency room visit or hospital admission over the last 6 months. The intervention was conducted at the primary care clinic or at the patient’s home, and aimed to include between 4 and 8 45-min sessions with a social worker. The patients identified problems in their lives and directed the focus of subsequent sessions as consistent with the steps of PST. A total of 568 problems were identified, 59% of which were resolved. The most commonly identified problems included health related issues such as need for exercise or weight loss activities, medical care and medical equipment needs, home and garden maintenance, and gathering information on their medical condition. Problems identified by patients were 2.2 times more likely to be solved than those identified by a health care professional. The article concludes that using PST in primary care may facilitate patients in addressing key health and wellness issues.
Integrating social workers into primary care: physician and nurse perceptions of roles, benefits, and challenges
- Authors:
- KEEFE Bronwyn, GERON Scott Miyake, ENGUIDANOS Susan
- Journal article citation:
- Social Work in Health Care, 48(6), August 2009, pp.579-596.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The primary aim of this article is to identify, from the perspective of primary care physicians and nurses, the challenges encountered in the provision of health care to older adults and to identify potential roles, challenges, and benefits of integrating social workers into primary care teams. As more older adults live longer with multiple chronic conditions, primary care has been confronted with complex psychosocial problems that interact with medical problems, pointing to a potential role for the social worker. Three focus groups of primary care physicians and nurses at 2 primary care clinics of a managed care organisation in a large metropolitan area were used to explore the benefits and challenges of integrating social workers into the primary care team. The focus groups discussed the perceived unmet needs of frail elders in the community, the roles social workers can play in addressing the needs of frail older adults, perceived challenges in integrating social workers in primary care, and ways in which social workers can improve service delivery and effectiveness of care. The results clearly identified a need for social workers in primary care practices, with both doctors and nurses feeling that this would result in improved patient care and outcomes both in response to patient problems and as a preventive measure to avoid crisis situations. The results also indicated a need to provide more information, particularly to physicians, about the skills and training of social workers, in order to maximise their impact as members of effective interdisciplinary teams.