Comparison of Tasks Reported As Significant to Oncology Social Work across Three Inpatient Settings: A Secondary Data Analysis

Background and Purpose: Social workers are key to providing high-quality psychosocial care to people experiencing chronic and life-limiting diseases like cancer. Unfortunately, health social workers' roles are poorly understood within healthcare systems, particularly in oncology social work (OSW). There is sparse research on the roles of OSWs in general and specifically for those whose primary work setting is inpatient care. In this study, we delineated and compared the roles of inpatient OSWs. Understanding these roles is necessary to explore the mechanisms that promote improved health and psychosocial outcomes among cancer patients.

Methods: The data for secondary analysis was from a nationwide survey of OSWs who worked in inpatient settings. The respondents were asked to provide demographic and work-related data and to rate the significance of 91 tasks to their practice. These items were rated on a six-point scale ranging from 0 (not applicable to my job) to 5 (extremely significant). Exploratory Factor Analysis was conducted, resulting in 34 tasks in eight factors. ANOVAs with Tukey's HSD were used to compare the three groups (i.e., cancer inpatient units, inpatient units with mixed diagnoses, and inpatient and outpatient cancer settings).

Results The sample included 240 OSWs, 55 in cancer inpatient units, 31 in mixed diagnoses inpatient units, and 154 in inpatient and outpatient settings.

Significant differences (p <.05) were found between OSWs on cancer units, who reported higher scores, than those on mixed diagnoses units for assisting with planning for long-term or end-of-life care, discharge planning, and facilitating communication between family and providers.

Significant differences (p < .05) were found between those on cancer units, who reported higher scores, and those working inpatient and outpatient for arranging and facilitating transitions to the community, discharge planning, assisting with planning for long-term or end-of-life care, facilitating communication between the family and providers, and coordinating health and wellness services. Those working inpatient and outpatient had higher scores for facilitating support groups, planning and participating in community events, and assuring compliance with psychosocial guidelines than those on cancer units.

Between those on inpatient units with mixed diagnoses and inpatient and outpatient cancer care, the significant finding (p < .05) was for facilitating support groups, where inpatient and outpatient OSWs reported higher scores.

Differences trending toward significance were found with three tasks. Those on cancer units reported higher scores than those on mixed units for participating in professional social justice activities and arranging and facilitating transitions to the community. Those in inpatient and outpatient had higher scores than those in mixed units for planning and participating in community events.

Conclusions and Implications: There were significant differences in eight tasks, and one trended toward significance. OSWs on inpatient cancer units had higher significant scores for five tasks, inpatient and outpatient for three, and the trending task was highest for those on cancer units. Future research needs to be done to identify the mechanisms of the delineated tasks on health and psychosocial outcomes and if having OSWs performing these tasks has better outcomes than other psychosocial providers.