Social Justice, Organizational Commitment and Palliative Care Practice

Background:

 The pursuit of social work education and a social work career is most often motivated by a desire to serve oppressed populations and engage in social justice work. 

Palliative care social workers are motivated by a desire to directly help individuals with a life-threatening medical condition and engage in work that is meaningful.  Most palliative care social workers engage in direct service level of practice, yet in a health care environment of systemic racial inequality and documented lower rates of palliative care utilization by minority populations, little research has examined social workers perception of social justice in palliative care and how this may influence job satisfaction and commitment to their organization. An exploration of how these social workers find satisfaction in their work opportunities, may be able to improve service delivery to diverse populations with chronic illness. 

The specific aims of this mixed methods study were to describe whether: 1) Social justice orientation was associated with job satisfaction, organizational commitment and intention to stay with their organization; and 2) how palliative care social workers understand social justice and systemic inequality in their work, and how this may influence their commitment to their organizations and intention to remain in their careers. 

Methods:

Data were collected using a cross-sectional survey design using online questionnaires and open-ended questions about palliative care and social justice. Participants (n=128) were recruited by use of a listserv accessed by palliative care social workers and snowball sampling. The survey instrument for this study included a combination of standardized scales, including the Social Justice Scale, the Intentions to Leave Scale, and the Organizational Commitment Scale. 

Results:

Those palliative care organizations that createdan environmentinformed by social justice norms, increasedorganizational commitmentamong palliative care social workers (β= 0.24, p= .045), this increased job satisfaction (β= 0.41, p< .001)and decreasedthe chances that they would want to leave the workplace (β= -0.31, p<.001).  Organizational commitmentmediated the relationships between social justice norms, job satisfaction, and intention to leave among the respondents.  Qualitative data revealed themes of satisfaction and intention to stay within micro level of practice and values of equality and need to improve access to resources in macro level of practice.  

Implications:

The focus on effecting social change to favor inclusivity and removing both individual and systemic barriers should be a priority to palliative care social workers and organizations.  Palliative care social workers may find more satisfaction in their work when practicing as the “whole social worker” at the micro, mezzo, and macro level of practice.

Suggestions for doing so include: 1) examining the current roles of palliative care social workers; 2) encourage palliative care organizations to offer opportunities for social workers to engage in work that reflects values related to social justice, advocacy and elimination of systemic inequality; and 3) develop advanced training for palliative care social workers to pursue leadership roles in macro level advocacy and to develop more responsive and comprehensive service delivery systems in palliative care.