Social Workers in Palliative Cancer Care: A Qualitative Study of Their Roles, Barriers, and Facilitators

Background and purpose: Palliative care offers significant benefits to the growing population of cancer patients and their families. Social workers play a vital role in delivering high-quality psychosocial services within palliative care settings. However, their specific roles in palliative cancer care remain undefined. To address this gap, this qualitative study aimed to answer the following questions: 1) What are the roles of social workers in palliative cancer care? 2) What are social workers’ perspectives on the barriers and facilitators of delivering these roles in palliative cancer care?

Methods: Using convenience sampling, we recruited social workers (n=10) working in palliative care with cancer patients in the United States through the Social Work Hospice and Palliative Care Network. Semi-structured interviews via Zoom were conducted between September and December 2023. These interviews were recorded and transcribed. Four authors independently checked for accuracy and then analyzed the transcripts. Inductive thematic analysis was used to identify the themes.

Results: Of the ten participants, 90% were female, 63% identified as White, and 88% held full licensure. Six main themes emerged regarding social workers’ roles in palliative cancer care: 1) psychosocial assessment, 2) therapeutic interventions, 3) family-centered support for spouses and children, 4) facilitation of communication and decision-making (e.g., advance directives), 5) care coordination, and 6) grief and bereavement. Three facilitators in delivering these roles were identified: the interdisciplinary collaboration nature of palliative care, shared information in electronic health records, and the support of regular and structured team meetings. Additionally, several key barriers were noted, including the misunderstanding of palliative care among patients and families, a lack of awareness and clarity of social worker’s roles and competences, high turnover rates among healthcare providers, and delayed referrals by the oncology team.

Conclusions and Implications: This study contributes to previous efforts to define the role of social work in palliative care and offers deeper insights into their roles in palliative cancer care. The findings emphasize the role of social workers in addressing psychological and social aspects of care, aligning with the Clinical Practice Guidelines for Quality Palliative Care. The identified barriers and facilitators may guide program development to ensure optimal care quality. Further research is crucial to substantiate the value of social workers in palliative care practice, interdisciplinary collaboration, patient outcomes, and cost-effectiveness.