McGregor Jules, Mercer Stewart W, Harris Fiona M
Health and Social Care Department, City of Edinburgh Council, Edinburgh, UK.
Department of Primary Care Research, University of Glasgow, Glasgow, UK.
Health Soc Care Community. 2018 Jan;26(1):1-13. doi: 10.1111/hsc.12337. Epub 2016 Apr 5.
The prevalence of complex health and social needs in primary care patients is growing. Furthermore, recent research suggests that the impact of psychosocial distress on the significantly poorer health outcomes in this population may have been underestimated. The potential of social work in primary care settings has been extensively discussed in both health and social work literature and there is evidence that social work interventions in other settings are particularly effective in addressing psychosocial needs. However, the evidence base for specific improved health outcomes related to primary care social work is minimal. This review aimed to identify and synthesise the available evidence on the health benefits of social work interventions in primary care settings. Nine electronic databases were searched from 1990 to 2015 and seven primary research studies were retrieved. Due to the heterogeneity of studies, a narrative synthesis was conducted. Although there is no definitive evidence for effectiveness, results suggest a promising role for primary care social work interventions in improving health outcomes. These include subjective health measures and self-management of long-term conditions, reducing psychosocial morbidity and barriers to treatment and health maintenance. Although few rigorous study designs were found, the contextual detail and clinical settings of studies provide evidence of the practice applicability of social work intervention. Emerging policy on the integration of health and social care may provide an opportunity to develop this model of care.
初级保健患者中复杂健康和社会需求的患病率正在上升。此外，最近的研究表明，心理社会困扰对该人群中明显较差的健康结果的影响可能被低估了。卫生和社会工作文献中广泛讨论了社会工作在初级保健环境中的潜力，并且有证据表明，社会工作在其他环境中的干预措施在满足心理社会需求方面特别有效。然而，与初级保健社会工作相关的具体健康改善结果的证据基础却很少。本综述旨在识别和综合关于社会工作干预在初级保健环境中的健康益处的现有证据。检索了1990年至2015年的九个电子数据库，检索到七项初级研究。由于研究的异质性，进行了叙述性综合分析。虽然没有确凿的有效性证据，但结果表明初级保健社会工作干预在改善健康结果方面具有潜在作用。这些包括主观健康指标和长期疾病的自我管理，减少心理社会发病率以及治疗和健康维持的障碍。虽然发现的严格研究设计很少，但研究的背景细节和临床环境为社会工作干预的实践适用性提供了证据。卫生与社会保健整合的新政策可能为发展这种护理模式提供机会。
