A qualitative interpretive meta-synthesis of social workers’ experience in end-of-life care

Abstract

Summary Social workers are an integral part of end-of-life (EOL) care interdisciplinary services and provide comprehensive psychosocial support to dying people. However, despite the rewards, EOL care social work is wrought with challenges. There is currently limited research into the experience of EOL care social workers. Therefore, this qualitative interpretive meta-synthesis (QIMS) study examines the experience of EOL care social workers as revealed in existing literature. The QIMS methodology was used to synthesize and interpret findings from four original qualitative studies to elicit an in-depth response to the research question: What is the experience of social workers who work in EOL care? Findings The theme “EOL care social work is a privilege and a struggle” emerged, with six associated contributing factors: Privilege—(1) death is sacrosanct, (2) death is an opportunity for growth and healing, and (3) the religious/spiritual element of EOL care. Struggle—(1) ongoing pain and heightened emotions, (2) conflict of values, and (3) contextual challenges. This QIMS study serves as a preliminary phase to a subsequent, larger study. Applications This QIMS study provides a foundation for further narrative research into the experience of EOL care social workers. In addition, findings from this QIMS study highlights areas for further attention to foster the well-being of EOL care social workers. Finally, findings from this QIMS study could augment relevant EOL care content in undergraduate social work education.

Social work at the end of life: Humanization of the process

“…They also need training in skills to help people and their caregivers in the assessment of the situation they are facing, to facilitate the choice of the support they will need, both formal and informal, or, for example, to work on community education and mobilize latent social resources in the community. There has been a clear demand for training in values and attitudes of respect for the person's weaknesses and wishes, sensitivity, compassion, respect for dignity, confidentiality, and, especially, in ethical knowledge, skills, and virtues that will enable them to face the frequent problems and dilemmas that arise in professional practice linked to care of this kind (Dewar et al, 2023).…”

‘So being here is. . . I feel like I’m being a social worker again, at the hospice’: Using interpretative phenomenological analysis to explore social workers’ experiences of hospice work

“…This echoes work conducted across country settings, in which having such conversations and helping people with progressive illnesses and nearing the end of life was seen as a privilege. 25 More surprising was that participants contrasted the role in the hospice with previous roles in social services, believing that they had much more autonomy and ability to connect with their values in the hospice. This may reflect the wider context of social work practice in the UK and multiple countries internationally, where there is a reported value crisis arising from the implementation of neoliberal and management principles, alongside reductions in welfare and social service provision.…”

“…Personal and team resilience, making a significant contribution to clients and families, and the ability to derive personal meaning from the work may all mitigate against emotional demands. [21][22][23][24] Existing literature, largely from the US and Australia highlights the rewarding and challenging role of social work in palliative care 25 including high levels related to stress, burnout and compassion fatigue. [26][27][28][29] Pelon identified a need to explore in-depth the experience of the work, 29,30 which shaped the current study.…”

“…Existing literature, largely from the US and Australia highlights the rewarding and challenging role of social work in palliative care 25 including high levels related to stress, burnout and compassion fatigue. 26 – 29 Pelon identified a need to explore in-depth the experience of the work, 29 , 30 which shaped the current study.…”

“… 9 However, little is known about hospice social workers’ emotional experience of their work. Research has highlighted that those involved in hospice work find the work both a struggle (for example because of heightened emotions) and rewarding (noting that social work in end-of-life care can feel like a privilege), 25 alongside the importance of meaning derived from the work. 31 However, there is recognition of a need to determine how to enhance worker well-being and mitigate the potential cumulative detrimental impacts of end-of-life care work.…”