Read more about the public defense in Norwegian by clicking on “Norwegian version”.
Summary
Grounded in a bio-psycho-social perspective, hospital social workers (HSW) will be part of interprofessional collaboration when helping patients. HSW work in a context in which acute and critical medical issues form the main mandate and must be dealt with continuously. The working context requires an understanding of a medical situation and the ability to adapt and apply current perspectives and knowledge that can help strengthen overall treatment. As part of this collaboration, HSW have a particular responsibility for promoting the interaction between health and social and psychosocial factors. This role requires the articulation of knowledge and practices based on the social work knowledge base.
Questions
Although the area of responsibility and work tasks of HSW can be perceived as a stable arrangement, conditions at the societal level and in the workplace will have an impact on the direction in which the profession develops. This doctoral thesis draws attention to jurisdictional processes that take place in the workplace by studying the practice of HSW in the acute phase of critical illness in children and young people. This has been explored from various perspectives based on the following questions:
- How do HSW justify their practice?
- How do they position themselves in interprofessional collaboration?
- How do they articulate their competencies?
The first article
This study is based on data from semi-structured individual interviews with 19 HSW associated with children’s and youth wards at 12 somatic hospitals in Norway. The thesis consists of three articles that explore the jurisdictional work of hospital social workers in different ways. In the first article, we ask: 1). How do HSW in acute paediatric care understand parents’ needs? and 2). How do they describe their contribution to these needs in ways that might strengthen parental health literacy? Based on descriptions of needs, interventions and reasonings of practices, the article links this to a health literacy perspective.
The second article
In the second article, we ask: What types of boundary work do HSW perform, and what means or strategies do they employ? Boundary work is used as an analytic concept to explore how HSW position themselves in interprofessional collaboration.
The third article
In the third article, we ask: What boundary-spanning competencies do HSW use in their professional practice? In this article, we explore competencies that are central to building bridges between people, organizations and different perspectives.
The findings of this thesis regarding justification for practice of HSW can be summarized by their desire to strengthen parents’ experiences of overviews, predictabilities and controls. Based on knowledge about different needs in an acute situation, the welfare system and different medical issues, HSW seek to strengthen parental health literacy through information
and guidance, identification of needs for medical information, taking care of emotional needs and building bridges between people and perspectives.
Findings
Regarding positioning within interprofessional collaboration, the findings point to two main strategies adopted by HSW. They want to appear as something distinct and different from other occupational groups. Positioning can take place by promoting social work perspectives, such as the relationship between living conditions and health, or by marking the boundaries of their own professional practices. At the same time, HSW seek interprofessional collaboration by building relationships and placing less emphasis on jurisdictional boundaries.
The findings point to a tendency to meet the needs of others rather than emphasize their own positions where these considerations come into conflict. The findings related to the articulation of competence show competences that can be related in various ways to personalized practice and the ability to take the perspective of others and build bridges between different interests and perspectives. The competences, which can be divided into cognitive, social and emotional, mutually influence each other. These competencies are applied when preparing for encounters and in encounters with families and other professionals.
Finally, the findings of this thesis highlight current interprofessional interaction mechanisms and competencies and underline the importance of including politically initiated social missions as part of practice justifications. Overall, the findings can be understood as a contribution to strengthening the legitimization of the practices, positions and competences of
HSW, which will have significance for jurisdictional processes. Increased knowledge of these various aspects will help strengthen an occupational group’s opportunity to influence its professionalization from within by taking an active part in jurisdictional processes at the workplace and societal levels. In turn, this could have an impact on professionalization from
above.
