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定义通科水平的缓和医疗社工的核心能力

Defining Core Competencies for Generalist-Level Palliative Social Work.

机构信息

MJHS Institute for Innovation in Palliative Care, New York, New York.

Fordham University Graduate School of Social Service, New York, New York.

出版信息

J Pain Symptom Manage. 2018 Dec;56(6):886-892. doi: 10.1016/j.jpainsymman.2018.09.002. Epub 2018 Sep 7.

Abstract

CONTEXT

Care provided to seriously ill patients by frontline social workers is a component of generalist-level palliative care. The core competencies for high-quality generalist-level palliative social work are necessary to promote training curricula and best practices but have not yet been defined in the U.S.

OBJECTIVE

The objective of this study was to develop consensus-derived core competencies for generalist-level palliative social work.

METHODS

Fifty-five proposed social work competencies were categorized by the eight domains of palliative care identified by the National Consensus Project for Quality Palliative Care. The competencies were rated by 41 regionally dispersed, Master's level social workers selected through purposive and snowball sampling using a Delphi method. Each was rated as essential for generalist-level palliative social work, acceptable with modifications, or rejected based on the judgment that it was not essential for generalist-level palliative social work or was outside the scope of practice. Consensus was defined as >70% agreement to accept or reject a competency. Three review rounds were needed to achieve consensus on all competencies.

RESULTS

Two competencies were added to the original list. Of the 57 proposed competencies, 41 were accepted (19 after modification) and 16 were rejected. Competencies in the social, spiritual, cultural, and ethical/legal aspects of care domains were relatively more likely to be accepted compared with those in structure and processes of care, physical care, psychological care, and care of patient at the end of life.

CONCLUSION

The 41 consensus-derived competencies for generalist-level palliative social work may inform the development of training curricula and standards for high-quality care.

摘要

背景

一线社工为重病患者提供的护理是通科姑息治疗的一个组成部分。高质量通科姑息治疗的核心能力对于促进培训课程和最佳实践是必要的,但尚未在美国确定。

目的

本研究旨在为通科姑息社会工作制定共识驱动的核心能力。

方法

55 项拟议的社会工作能力被归类为国家共识项目确定的姑息治疗的 8 个领域。通过使用德尔菲法的目的性和滚雪球抽样,从 41 名分布在不同地区的硕士水平社工中对这些能力进行了评分。每项能力都根据其对通科姑息社会工作的重要性进行了评估,分为必要、可修改和拒绝。必要是指对于通科姑息社会工作是必不可少的,可修改是指需要修改才能被接受,拒绝是指对于通科姑息社会工作不是必不可少的,或者超出了实践范围。共识定义为>70%的人同意接受或拒绝一项能力。需要三轮评审才能就所有能力达成共识。

结果

在原始清单中增加了两项能力。在提出的 57 项能力中,有 41 项被接受(19 项经修改后被接受),16 项被拒绝。在关怀的社会、精神、文化和伦理/法律方面的能力比关怀的结构和过程、身体关怀、心理关怀和临终关怀的能力更有可能被接受。

结论

通科姑息社会工作的 41 项共识能力可能为培训课程和高质量关怀的标准制定提供信息。

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