Die maatskaplike werker as ondersteuningsbron vir geneeshere in privaat praktyk

Vogt, Tertia (2001-12)

Thesis (MSocialWork)--Stellenbosch University, 2001.

Thesis

ENGLISH ABSTRACT: The aim of this study was to compile practical guidelines to assist medical practitioners in utilizing social work services in their practices. Exploratory, descriptive and applied research was done to determine and describe medical practitioners' knowledge of psychosocial problems and their present and potential utilization of social work services. Results were generalized in respect of the population as a whole. In the theoretical study social functioning was conceptualized by the description of micro, mezzo and macro levels of functioning. The approach towards rendering of services (in the Medical field) and intervention (in the Social Work field) was described, followed by recommendations for the eclectical utilization of the approaches. The eclectical application of the intervention approaches requires that social workers should have certain knowledge, values and skills to interpret certain roles. This occurs within certain social work areas, with the achievement of the aims and functions of Social Work as goal. The ethical and value basis of Social Work and Medical Science shows certain similarities and disparities. The values of Social Work, as contained in the Behavioural- and Ethical Code for Social Work and the Oath of Hippocrates, in Medical Science, are described in this study. In the empirical study qualitative and quantitative information was gathered, inter alia, about the existence of psychosocial problems of patients in medical practitioners' practices, how medical practitioners handled them, how well equipped they were to do it, their present and potential utilization of Social Work services, the role of third parties in the rendering of services and referral procedures. Thirty nine (39) medical practitioners, selected by random sampling procedure, were involved in the study and completed selfadministered questionnaires. The majority respondents indicated that their undergraduate training was inadequate in enabling them to handle psychosocial problems of patients. The entire spectrum of psychosocial problems existed in all the respondents' practices. The majority of respondents handled such problems themselves, while specialists, psychologists and psychiatrists were at times used as resources. The majority of respondents indicated that they could perhaps utilize Social Work services and that there is a great need for such a resource. Most medical practitioners preferred to send written referrals via patients, with the responsibility being with the patient for making an appointment with the social worker. Minimal use was made of third parties in the patients' frame of reference in the assessment and treatment of patients. Third parties, within the reference framework of patients, were used minimally by medical practitioners in the making of assessments and the rendering of services. Respondents had divergent opinions regarding their competence in the psychosocial field of service rendering. The majority of respondents indicated the need for training programs focusing on the handling of patients' psychosocial problems. Limited time for attending such training programs was however mentioned as the biggest obstacle. These findings of the empirical study, together with the theoretical framework, were used as a guideline for the composition of a practical guideline for the referral of services to social workers in private practice.

AFRIKAANSE OPSOMMING: Die doelstelling van hierdie studie was om praktykriglynne te ontwikkel, waarvolgens geneeshere in privaat praktyk maatskaplike werkers as ondersteuningshulpbron kan benut. Verkennende, beskrywende en toegepaste navorsing is gedoen, ten einde geneeshere se kennis van psigososiale probleme en hul huidige en potensiele benutting van maatskaplikewerkdienste te bepaal en te beskryf. Bevindinge is ten opsigte van die populasie as geheel veralgemeen. In die teoretiese studie is maatskaplike funksionering deur die beskrywing van mikro-, meso- en makrovlakfunksionering, gekonseptualiseer. Die benaderings tot dienslewering (in Geneeskunde) en intervensie (in Maatskaplike Werk) is beskryf. Daarna is 'n aanbeveling vir die eklektiese benutting van die benaderings gedoen. Die eklektiese benutting van die intervensiebenaderings vereis dat maatskaplike werkers oor sekere kennis, waardes en vaardighede moet beskik en sekere rolle moet vertolk. Dit geskied binne sekere maatskaplikewerkvelde en het as mikpunt die verwesenliking van die doelstellings en funksies van Maatskaplike Werk. Die etiese en waardegrondslag van Maatskaplike Werk en Geneeskunde toon sekere ooreenkomste en verskille. Die waardes van Maatskaplike Werk, soos vervat in die Gedrags- en Etiese Kodes vir Maatskaplike Werk, en van Geneeskunde, soos vervat in die Eed van Hippocrates, word in hierdie studie bespreek. In die empiriese studie is kwalitatiewe en kwantitatiewe inligting ingesamel oor, onder andere, die voorkoms van psigososiale probleme by pasiente in geneeshere se praktyke, geneeshere se hantering daarvan, hul bekwaamheid om sodanige probleme te hanteer, hul huidige en potensiele benutting van maatskaplikewerkdienste, die rol van derde partye by dienslewering en verwysingsprosedures. Nege-en-dertig (39) geneeshere, geselekteer deur ewekansige steekproeftrekking, is by die ondersoek betrek en het self die vraelyste ingevul. Die meeste geneeshere het aangedui dat hul voorgraadse opleiding hulle nie voldoende toegerus het om psigososiale probleme by pasiente te hanteer nie. Die hele spektrum van psigososiale probleme het in respondente se praktyke voorgekom. Die meeste respondente het sodanige probleme self hanteer, terwyl spesialiste, sielkundiges en psigiaters soms as hulpbronne benut is. Die meeste respondente het aangetoon dat hulle moontlik van maatskaplike werkers gebruik kan maak en dat daar 'n groot behoefte aan sodanige hulpbron bestaan. Die verwysingsprosedure wat deur die meeste geneeshere verkies is, was die stuur van skriftelike verwysings saam met pasiente. Derde partye, in pasiente se verwysingsraamwerk, is minimaal deur geneeshere by assessering en dienslewering betrek. Geneeshere het uiteenlopende menings gehad oor hul bevoegdhede in die psigososiale veld van dienslewering. Die behoefte aan opleidingsprogramme, wat fokus op die hantering van psigososiale probleme by pasiente, is deur die meeste respondente aangedui. Beperkte tyd is egter as die grootste struikelblok vir die bywoning van sodanige opleidingsessies aangevoer. Hierdie bevindinge van die empiriese studie, saam met die teoretiese raamwerk, is as riglyn benut vir die ontwikkeling van 'n praktykriglyn vir verwysing van dienste na maatskaplike werkers in privaat praktyk.

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