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Chapter 12 Social Work and Services in Health Care

Chapter 12 Social Work and Services in Health Care. Five key factors causing or contributing to health problems: 1) People who pursue unhealthful lifestyles. SA, smoking, overweight, etc. 2) Physical injuries. Accidents, suicide, vehicle accidents, etc.

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Chapter 12 Social Work and Services in Health Care

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  1. Chapter 12 Social Work and Services in Health Care

  2. Five key factors causing or contributing to health problems: 1) People who pursue unhealthful lifestyles. SA, smoking, overweight, etc. 2) Physical injuries. Accidents, suicide, vehicle accidents, etc. 3) Environmental factors. Air pollution. Ex. During 1990s breathing air in Mexico City during one day was the equivalent of smoking 2 packs of cigarettes. 4) Poverty. Unsanitary living conditions, hazardous work conditions, etc. 5) Contagious disease. STDs, HIV, etc. Health Problems

  3. Social Work Roles in Health Care Social Work Roles in Direct Health Care Practice Hospitals, Medical Clinics, and Diagnostic and Treatment Centers Help pts understand & interpret technical medical jargon, offer emotional support, help terminally ill people deal w/ their feelings and make end of life plans, help parents of children who have serious illness or disabilities cope, help pts make financial arrangements to pay medical bills, etc. Public Health Departments and Other Health Care Contexts SW can work in community and mental health facilities, family planning clinics, American Cancer Society, March of Dimes, etc. Veterans Affairs VA manages biggest health care operation in US serving 5.6 million veterans at 1300 locations. Largest employer of MSWs in country with over 4500 workers Managed Care Settings SW can work at a HMOs. Health maintenance org provide a wide range of health-care services for participants and employers, who typically pay an established monthly fee for service.

  4. Health Care Policy and Problems in the Macro Environment Four main issues that plague the U.S. health care system. 1) Expenses are escalating dramatically. U.S. health care system costs more than any other in the world. 2) People have unequal access to adequate health care. 45.7 million Americans lack any health insurance. All industrialized countries except for the U.S. have established some kind of national system so that all citizens have access to some type of health care coverage. 3) SW and other workers plagued w/ ethical dilemmas. 4) Cultural competence in responding to needs of various ethnic, racial, and cultural groups.

  5. Value Dimensions in Asian Americans and Pacific Islanders (API) Cultures Relating to Health Care Provision Filial Piety – a devotion to and compliance w/ parental and familial authority, to the point of sacrificing individual desires and ambitions. Collective Versus Individual Decision Making – reliance on family. Emphasis on Harmony Versus Conflict – individuals must endure hardship and pain especially if addressing issues that might disturb the family. Nonverbal Communication – values silent or nonverbal communication Fatalism – the conception that events are fixed in advance so that human beings are powerless to change. Shame at Asking for Help – family strongly prefer to deal w/ issues and illnesses within the family, rather than expose problems to outsiders.

  6. Conflicts Between API Cultural Values and the U.S. Health Care System Informed Consent – a person’s right to receive adequate information about the consequences and risks of medical procedure, treatment process, evaluate alternatives, and give permission for a procedure before it’s begun. In the API culture it is customary for all family members to received the same level of detail about pt’s diagnosis, prognosis, and treatment options. Advance Directives – written, witnessed, signed instructions regarding what individuals wish to have done in the event that they are unable to make decisions. API culture use a collectivist approach and assume that all family members will make decisions, not just one. Decisions About Nursing Home Placement – in the API culture filial piety means that the children care for ill parents, not send them to a nursing home. Many traditionally expect death to occur at home. Disclosure of Terminal Illness – telling a pt about ensuing death can be seen as taboo in the API culture. Some feel pt will lose strength and hope needed if they receive such news. End-of-Life Decisions – the decision of whether to continue life support for individuals who cannot make decisions and have no hope of recovery. Traditional API cultures tend to rebuff advanced directives. Cultural values emphasize longevity over quality of life, especially for one’s parent.

  7. International Perspectives: AIDS—A Global Crisis HIV and AIDS – In 2007, 2.1 million people died from AIDS. AIDS, caused by HIV is a disease that destroys the body’s immune system. Infected people gradually become vulnerable to opportunistic diseases – conditions and infections that themselves are not life threatening but with a weakened immune system use the opportunity to invade it. HIV gradually destroys the immune system, so it may take a while to develop AIDS. An AIDS diagnosis applies when a person has a positive HIV blood test and a CD4 T-cell count below 200 per cubic millimeter of blood. T cells fight off disease invading the body. The type of T cell that is vulnerable to HIV is the CD4 T cell. How is HIV Transmitted? Highlight 12.4 – HIV transmission can occur through sexual intercourse w/ HIV positive partner, using hypodermic needles, blood transfusion, babies can contract before birth from infected mother, and after birth in breast milk.

  8. No cure for HIV or AIDS, however drug treatments, cocktail drugs, have enhanced the health of people infected with HIV and have lengthened their life spans. Cocktail drugs annual cost is about $20,000 per person. AIDS is the only disease requiring meticulous compliance. If a patient misses even a pill or two a month the virus can mutate, figuring out how to resist the drug and forcing patients to switch regimens. Empowerment is key for social workers helping persons with AIDS. SW role is to provide support, focus on strengths, and seeking empowerment of persons w/ the disease. Treatment for AIDS and Empowerment for People Living with AIDS

  9. International Perspectives: AIDS in Sub-Saharan Africa Currently 27 million pple are HIV-positive in sub-Saharan Africa. Stigma associated w/ AIDS, pple cling to denial and do not receive treatment. Males are always in charge. Women who refuse sex or request a condom can suffer severe beatings. Many myths surround condoms. What can be done? Extensive prevention programs and education. Empower women to take control of their sex lives. Develop low-cost contraception that they have more control over. Develop financial contributions to aid in subsidizing drug costs for treatment. International Perspectives: HIV in Thailand The boom in the sex industry is causing the spread of AIDS. Poverty is leading families young women to prostitution with tourists. The Thai gov’t is attempting to address the issue by initiating sex education in schools and providing easy access to condoms.

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