social work research review

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Social Work Literature Review Guidelines

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Literature reviews are designed to do two things: 1) give your readers an overview of sources you have explored while researching a particular topic or idea and 2) demonstrate how your research fits into the larger field of study, in this case, social work.

Unlike annotated bibliographies which are lists of references arranged alphabetically that include the bibliographic citation and a paragraph summary and critique for each source, literature reviews can be incorporated into a research paper or manuscript. You may quote or paraphrase from the sources, and all references to sources should include in-text parenthetical citations with a reference list at the end of the document. Sometimes, however, an instructor may require a separate literature review document and will have specific instructions for completing the assignment.

Below you will find general guidelines to consider when developing a literature review in the field of social work. Because social work is a social science field, you will most likely be required to use APA style. Please see our APA materials for information on creating parenthetical citations and reference lists.

1. Choose a variety of articles that relate to your subject, even if they do not directly answer your research question. You may find articles that loosely relate to the topic, rather than articles that you find using an exact keyword search. At first, you may need to cast a wide net when searching for sources.

For example: If your research question focuses on how people with chronic illnesses are treated in the workplace, you may be able to find some articles that address this specific question. You may also find literature regarding public perception of people with chronic illnesses or analyses of current laws affecting workplace discrimination.

2. Select the most relevant information from the articles as it pertains to your subject and your purpose. Remember, the purpose of the literature review is to demonstrate how your research question fits into a larger field of study.

3. Critically examine the articles. Look at methodology, statistics, results, theoretical framework, the author's purpose, etc. Include controversies when they appear in the articles.

For example: You should look for the strengths and weaknesses of how the author conducted the study. You can also decide whether or not the study is generalizable to other settings or whether the findings relate only to the specific setting of the study. Ask yourself why the author conducted the study and what he/she hoped to gain from the study. Look for inconsistencies in the results, as well.

4. Organize your information in the way that makes most sense. Some literature reviews may begin with a definition or general overview of the topic. Others may focus on another aspect of your topic. Look for themes in the literature or organize by types of study.

For example: Group case studies together, especially if all the case studies have related findings, research questions, or other similarities.

5. Make sure the information relates to your research question/thesis. You may need to explicitly show how the literature relates to the research question; don't assume that the connection is obvious.

6. Check to see that you have done more than simply summarize your sources. Your literature review should include a critical assessment of those sources. For more information, read the Experimental Psychology - Writing a Literature Review handout for questions to think about when reading sources.

7. Be sure to develop questions for further research. Again, you are not simply regurgitating information, but you are assessing and leading your reader to questions of your own, questions and ideas that haven't been explored yet or haven't been addressed in detail by the literature in the field.

Social Work Research: Literature Reviews

• Getting Started
• Finding Scholarly Articles
• Citation Searching
• Evaluating Sources This link opens in a new window
• Literature Reviews
• Evidence-Based This link opens in a new window
• Finding Instruments This link opens in a new window
• Writing & Citing

Using A Literature Review

A literature review is a very practical part of the research process.  It's how you build on other research in the field - identify best practices and tools and learn what doesn't work.  The resources on the page are here to help you structure you literature review so it's as useful as possible.  

Also take a look at any literature reviews you find as you search for articles - in addition to content and further references they'll also provide helpful structural hints. 

• Social Work Literature Review Guidelines Literature reviews are designed to do two things: 1) give your readers an overview of sources you have explored while researching a particular topic or idea and 2) demonstrate how your research fits into the larger field of study, in this case, social work.
• Considerations in Writing a Literature Review This article will briefly outline key points for you to keep in mind when writing literature reviews for social work.
• Undertaking a literature review: a step-by-step approach The purpose of this article is to present a step-by-step guide to facilitate understanding by presenting the critical elements of the literature review process. While reference is made to different types of literature reviews, the focus is on the traditional or narrative review that is undertaken, usually either as an academic assignment or part of the research process.

Conducting a Literature Review & Other Research Methods

What is a Literature Review?

"Literature reviews are systematic syntheses of previous work around a particular topic. Nearly all scholars have written literature reviews at some point; such reviews are common requirements for class projects or as part of theses, are often the first section of empirical papers, and are sometimes written to summarize a field of study. Given the increasing amount of literature in many fields, reviews are critical in synthesizing scientific knowledge." - Encyclopedia of Research Design

• APA Style Sample Papers (seventh edition) by the APA
• Sample APA Paper (lit. review begins page 3)
• Dissertations and Theses Full-Text Global Search here for examples of literature reviews from masters and doctoral theses.

Thinking About A Literature Review

Literature Reviews: An Overview

Additional How-To Guides

• CSU, Chico Office of Graduate Studies - Thesis Assistance Instructions, policies, and guidelines for graduate studies theses/projects.
• CSU, Chico Writing Center Make a one-on-one appointment with a writing tutor to help with your writing assignments.
• Learn How to Write a Review of the Literature University of Wisconsin-Madison
• Literature Review: An Overview for Graduate Students Video overview by North Carolina State University Libraries
• Literature Review: The What, Why and How-to Guide University of Connecticut University Libraries
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Research on Social Work Practice

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There is a growing movement in social work toward a more empirical selection of therapies and interventions because, to be effective, you have to know what works. As the community of practitioners, scholars and students interested in applying scientific methods of analysis to social work problems continues to grow, the need for a publication dedicated to social work practice outcomes has never been greater. Research on Social Work Practice is the first professional social work journal to focus on evaluation research and on validating methods of assessment in social work practice.

Vital Information Research on Social Work Practice is a disciplinary journal devoted to the publication of empirical research concerning the assessment methods and outcomes of social work practice.  Social work practice is broadly interpreted to refer to the application of intentionally designed social work intervention programs to problems of societal or interpersonal importance.  Interventions include behavior analysis and therapy; psychotherapy or counseling with individuals; case management; education; supervision; practice involving couples, families, or small groups; advocacy; community practice; organizational management; and the evaluation of social policies.

The journal primarily serves as an outlet for the publication of:

• Original reports of evidence-based evaluation studies on the outcomes of social work practice.
• Original reports of empirical studies on the development and validation of social work assessment methods.
• Original evidence-based reviews of the practice-research literature that convey direct applications (not simply implications) to social work practice.  The two types of review articles considered for publication are: 1) reviews of the evidence-based status of a particular psychosocial intervention; and 2) reviews of evidence-based interventions applicable to a particular psychosocial problem.

Comprehensive Coverage Each issue of Research on Social Work Practice brings you the latest scholarship to help bridge the gap between research and practice. Regular features include: Outcome Studies New Methods of Assessment Scholarly Reviews Invited Essays Book Reviews

In-Depth Special Issues Research on Social Work Practice frequently supplements its broad coverage with in-depth studies of topics of particular concern through Special Issues or Special Sections. Previous examples include:

• Research on Social Work Practice in Chinese Communities (Vol.12, n.4)
• Honoring Walter W. Hudson (Vol.12, n.1)
• Flexner Revisited (Vol.11, n.2)
• Research on Social Work Practice in Ireland (Vol.10, n.6)
• Technology and Social Work (Vol.10, n.4)
• Australian Social Work Research (Vol.10, n.2)

By connecting practice and research in an artful and readable fashion, RSWP has provided a synergy for the helping professions — the vital recognition that without research, practice is blind; and without practice, research is mute. — Martin Bloom Professor, School of Social Work, University of Connecticut In the relatively few years since its inception, Research on Social Work Practice has become one of the most highly respected and frequently cited journals in our field. Researchers, practitioners, and students have all found its contents to be invaluable in their work. — Dianne Harrison Montgomery Dean and Professor, School of Social Work, Florida State University   The unique manner in which the editors cover the broad spectrum of research on social work practice is destined to make the journal become a classic in the field. This is a must reading for all engaged in any level of practice research. — Moses Newsome, Jr. Dean, School of Social Work, Norfolk State University Past-President, Council on Social Work Education This journal is a member of the Committee on Publication Ethics (COPE) .

Research on Social Work Practice , sponsored by the Society for Social Work and Research, is a disciplinary journal devoted to the publication of empirical research concerning the methods and outcomes of social work practice. Social work practice is broadly interpreted to refer to the application of intentionally designed social work intervention programs to problems of societal and/or interpersonal importance, including behavior analysis or psychotherapy involving individuals; case management; practice involving couples, families, and small groups; community practice education; and the development, implementation, and evaluation of social policies.

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Guidelines for Authors

Research on Social Work Practice (RSWP) is a peer-reviewed disciplinary journal devoted to the publication of empirical research concerning the outcomes of social work practice. Social work practice is broadly interpreted to refer to the application of intentionally designed social work intervention programs to problems of societal and/or interpersonal importance. Interventions include, but are not limited to, behavior analysis and therapy, psychotherapy or counseling with individuals, cognitive therapy, case management/care coordination, education, supervision, practice involving couples, families, or small groups, advocacy, community practice, organizational management, and the evaluation of social policies. At least one author of a submitted article must be a professional social worker, and/or the interventions evaluated must have been provided by professional social workers.

The journal will primarily serve as an outlet for the publication of:

1. Original reports of empirically-based evaluation studies on the outcomes of social work practice;

2. Systematic reviews or meta-analyses of the practice-research literature that convey direct applications (not simply implications) to social work practice. The only two types of systematic reviews considered for publication are:

A. Systematic reviews of the evidence-based status of a particular psychosocial intervention or assessment method, or B. Systematic reviews of different psychosocial interventions applicable to clients with a particular psychosocial problem.

The journal welcomes empirical research appropriately derived from a variety of etiological and intervention theories, as well as studies which focus on evaluations not based upon formal theoretical frameworks. Studies using diverse methodologies, such as group or single-system research designs, qualitative approaches, mixed methods approaches, and interdisciplinary works are welcome to be submitted. Replication studies are welcome, as are well-designed studies with negative findings or reports of treatment failures. Authors are encouraged to submit only articles of the highest quality for editorial review and possible publication. The submission of seriously flawed or marginal studies is discouraged. Reports of inferential statistics involving significant differences must be accompanied by suitable measures of effect sizes and their appropriate confidence intervals, and include a discussion of the practical impact indicated by these effects.

Articles reporting original research involving data collection from human beings must include a statement indicating the source of Institutional Review Board Approval (blinded in the original submission) or a clear statement addressing why IRB review was not necessary.

Manuscripts which do not fit into one of the above two categories should not be submitted, and if received will be promptly returned to the author un-reviewed. Occasionally other types of submissions are published in the journal (e.g., guest editorials, conference proceedings, research center descriptions), but these are usually invited and accepted at the discretion of the Editor.

Inappropriate Submissions: The journal does not usually publish narrative case studies, surveys, program descriptions, theoretical, philosophical or conceptual works, correlational investigations, historical reviews, retrospective predictor studies, purely methodological articles, descriptive studies, or needs assessments. The journal no longer accepts for review psychometric studies, reports of the development and validation testing of measurement methods useful for research or practice . Authors are urged to submit such studies to the many other social work journals which do not have the intervention-research focus of Research on Social Work Practice . The journal publishes occasional special issues devoted to a particular topic and readers with an interest in proposing a topic for such a special issue and to serve as a Guest Editor for that issue are welcome to contact the Editor.

Authors are encouraged to make pre-publication use of a data-depository ( http://www.nature.com/sdata/policies/repositories#general ) to ensure post-publication access to their data and to indicate this in the submitted manuscript. At a minimum, reports of original data-based research should include a statement from the authors indicating where qualified researchers may obtain a copy of the data and data-coding manual (this is usually the corresponding author). This stipulation is to encourage transparency in the reporting process and to promote re-analysis and replication efforts by independent scholars.

Authors whose native language is not English are encouraged to have their submission carefully edited by English language experts prior to submission. Sage Publications Inc. offers such a service, which can be located at: http://languageservices.sagepub.com/en/

Authors not familiar with current APA style are encouraged to review the free online style guides provided by the American Psychological Association, which can be located at:

http://www.apastyle.org/index.aspx?_ga=1.161514751.2121075784.1468782120 . Submissions out of compliance with APA style will be returned un-reviewed.

As part of our commitment to ensuring an ethical, transparent and fair peer review process Sage is a supporting member of ORCID, the Open Researcher and Contributor ID . 

ORCID provides a unique and persistent digital identifier that distinguishes researchers from every other researcher, even those who share the same name, and, through integration in key research workflows such as manuscript and grant submission, supports automated linkages between researchers and their professional activities, ensuring that their work is recognized. 

We encourage all authors and co-authors to link their ORCIDs to their accounts in our online peer review platforms. It takes seconds to do: click the link when prompted, sign into your ORCID account and our systems are automatically updated. We collect ORCID iDs during the manuscript submission process and your ORCID iD then becomes part of your accepted publication’s metadata, making your work attributable to you and only you. Your ORCID iD is published with your article so that fellow researchers reading your work can link to your ORCID profile and from there link to your other publications.

If you do not already have an ORCID iD please follow this link to create one or visit our ORCID homepage to learn more.

Research on Social Work Practice (RSWP)  may accept submissions of papers that have been posted on pre-print servers; please alert the Editorial Office when submitting and include the DOI for the preprint in the designated field in the manuscript submission system. Authors should not post an updated version of their paper on the preprint server while it is being peer reviewed for possible publication in the journal. If the article is accepted for publication, the author may re-use their work according to the journal's author archiving policy.

If your paper is accepted, you must include a link on your preprint to the final version of your paper.

Visit the Sage Journals and Preprints page for more details about preprints.

Guidelines for Preparing Quantitative Outcome Studies

The journal requires that accepted quantitative manuscripts be formatted in compliance with the Journal Article Reporting Standards (JARS) found in the sixth edition of the APA Publication Manual . Note that apart from general guidelines, there are separate additional guidelines for reporting quasi-experimental and experimental studies, as well as for meta-analyses. There are also guidelines for reporting a study participant flow chart, which should be included in nomothetic outcome studies. Mixed methods papers including quantitative analyses should have these elements of the article compliant with these guidelines. Causal inferences, if any, should be made conservatively and not go beyond the limits imposed by the presented methods and data.

Single-case research studies which build upon traditional case narrative reports by adding the systematic and empirical measurement of clinically relevant variables (e.g., client’s problems or strengths) before, during and after treatment begins, are welcome submissions. Outcome measures must have acceptable levels of reliability and validity, the intervention must be well-described, and any causal inferences drawn must not go beyond those legitimately derived from the data. Data must be presented in the form of line graphs. The guidelines by Kratochwill et al. (2010) are recommended in this regard.

Articles reporting the results of a quasi-experimental outcome study must follow the standards found in the Transparent Reporting of Evaluation Studies using Nonrandomized Designs (TREND) checklist. Include a completed TREND Checklist as an appendix to your paper. See http://www.cdc.gov/trendstatement/ .

Articles reporting a randomized controlled trial must follow the Consolidated Reporting Standards for Randomized Trials (CONSORT), and include a completed CONSORT Checklist. See http://www.consort-statement.org/consort-statement/ . The authors of outcome studies evaluating non-pharmacological interventions (e.g., psychosocial treatments) are urged to familiarize themselves with relevant guidelines useful for reporting such studies. Grant et al. (2013) is a recommended resource for authors to consult, as is Boutron, Ravaud and Moher (2012).

Authors submitting a randomized clinical trial (RCT) or quasi-experimental outcome study for review and publication are strongly encouraged to have pre-registered their study protocol in a suitable clinical trials registry , such as clinicaltrials.gov. The article by Harrison and Mayo-Wilson (2014) can provide guidance regarding the rationale for and process of pre-registering their protocol. The submitted article should include a statement giving the reference to any clinical trials registry they have submitted their protocol to.

Guidelines for Preparing Systematic Reviews and Meta-Analyses

RSWP welcomes well-crafted empirically-based reviews of the treatment literature. Such manuscripts should present either the evidence regarding a particular psychosocial intervention , various interventions for a particular psychosocial problem or a critical review of treatment studies focused on a particular disorder, problem or condition. Review articles should have a clear social work focus, and cite the relevant social work literature, if any exists, in addition to pertinent findings from the broader behavioral and social sciences. Manuscripts of this type should provide the reader with clear and compelling applications to practice, not untested implications.

Articles claiming to be a Systematic Review should adhere to the guidelines for preparing systematic reviews developed by the Cochrane Collaboration (Higgins & Green, 2009) or the Campbell Collaboration (2014). In addition, the authors of systematic reviews and meta-analyses must follow the guidelines found in the PRISMA Statement ( Preferred Reporting Items for Systematic Reviews and Meta-analyses ), found at: http://www.prisma-statement.org/ .

If the article does not follow these standards, the paper should be titled as A Narrative Review, or simply A Review , and the specific term Systematic Review should be avoided.

Authors submitting a systematic review for review and publication are strongly encouraged to have pre-registered the review protocol in a suitable registry, such as PROSPERO ( www.crd.york.ac.uk/PROSPERO ). The article by Stewart, Moher and Shekelle (2012) can provide guidance regarding the rationale for and process of pre-registering systematic review protocols. The submitted article should include a statement giving the reference to any registry in which the protocol is published.

The EQUATOR Network (Enhancing the QUAlity and Transparency of Health Research) is a recommended resource for authors preparing studies for submission to RSWP which deal with the general topic of health care. See http://www.equator-network.org/ .

Completed copies of relevant TREND, CONSORT or PRISMA checklists should be included as a separate supplemental file when submitting the manuscript online.

Guidelines for Preparing Qualitative Studies

RSWP welcomes well-written rigorous qualitative outcome studies. Studies of the processes of an intervention, absent credible evidence that the intervention actually produces positive effects, are not invited for submission. Authors are encouraged to judiciously take advantage of the journal’s lack of a page limitation and craft a manuscript that details the context and methods to provide transparency of the study. The qualitative methodology used must be consistent throughout the study. The sampling, data collection, and analysis should make sense considering the chosen research question and the method. Authors should describe strategies employed to ensure the trustworthiness and credibility of the study, and provide a replicable audit trail. Qualitative data analysis software may be appropriately used in the analysis, but is not required. For suggestions on creating well-written qualitative article consult Fawcett et al. (2014), Staller and Krumer-Nevo (2013) and Pratt (2009).

How to submit a manuscript: The journal requires authors to use the MANUSCRIPT CENTRAL web-based portal to submit their manuscripts. The submission portal is available via http://mc.manuscriptcentral.com/rswp

Use of the Journal Article Reporting Standards: All submissions are required to be prepared using the formatting standards found in the 6th Edition (2010) of the APA Publication Manual. Authors of data-based papers are specifically asked to adhere to the relevant Journal Article Reporting Standards (JARS). The Editor is available to consult with you about any questions you may have regarding complying with these standards. They have been adopted to help promote consistency in research reporting, to try and further elevate the standards of work appearing in Research on Social Work Practice , and to ultimately improve the credibility of research findings available to the profession and the public. The abstracts of research articles must include the following headings: Purpose:, Methods:, Results:, Conclusions:. Manuscripts not adhering to current APA style conventions will be returned to the authors un-reviewed and with a request to revise their paper and to resubmit it. A very common error is for authors to inappropriately include the issue number following the volume number, in citations to articles appearing in journals paginated by year. See the APA manual if you are not clear when issue numbers should and should not be included. Some bibliographic software programs automatically include issue numbers, and these should be manually deleted, if necessary.

All manuscripts should include an abstract on a separate page that contains no more than 150 words, and also a separate title page (designated as Title Page) which includes: 1) title of the article; 2) corresponding author's full name, current position, affiliation, institutional and email address, telephone and fax numbers; 3) co-author(s)' full name(s) and affiliation(s); 4) up to five key words as they should appear if they were to be published. Manuscripts will not be considered for submission if they do not include these elements. Tables and/or Figures are to be included when necessary to depict the results. There is no specific limit on the total number of pages, tables or figures.

Authors submitting manuscripts are protected by common law against the unauthorized use of their unpublished work. Specifically, an unpublished manuscript is considered to be a confidential or privileged paper. All reviewers will be asked to destroy or return the manuscript after their review is completed; in addition, reviewers will be asked not to circulate, quote, cite, or refer to the unpublished work in any way unless specific permission is granted by the author.

Artwork Submissions

High-resolution figures should be uploaded as separate electronic files, with callouts for each in the text. Figure legends should include full explanations of the figures and be typewritten double-spaced with numbers corresponding to those on the figure files themselves. All figures must be specifically referred to in the text and numbered in order of appearance in the text. Acceptable file formats for figures include TIFF, EPS, and JPEG, and PDF Microsoft Application Files are acceptable for vector art (line art). Permission for use of the copyrighted material is the responsibility of the author. All artwork must be camera ready.

Tables should be numbered consecutively corresponding to in-text citation. Each table should be prepared on a separate page at the end of the text document and preferably should be no larger than a single page. Include a brief descriptive title of the table and a footnote with explanation of any abbreviations. All tables must be specifically referred to in the text for placement and numbered in order of appearance in the text. Elements in tables should be separated by tabs, not cells or lines.

Conflict of Interest

Authors are required to disclose any commercial, financial, or other associations that could pose a conflict of interest in connection with their submitted article and these must be disclosed on the title page at the time of submission.

Financial Disclosure/Funding

Authors should list all funding sources (and ID numbers, as appropriate) related to the study and to the article preparation.

Once a manuscript is accepted for publication, the corresponding author will be required to complete an electronic copyright transfer form. From SageTRACK website “Corresponding Author Center” choose the correct manuscript from “Manuscripts with Decisions” and from the ACTION box on the far right side, choose “Contributor Form.” After reading the form and completing the appropriate boxes, clicking the “I accept” box will confirm appropriate copyright transfer.

Authors are required to submit written permission from the original publisher to reprint copyright-protected material, including quoted material of 300 words or more from a single source (journal article or book).

Submission of a manuscript implies commitment to publish in this journal. Authors submitting manuscripts to the journal must not simultaneously submit them to another journal, nor should manuscripts have been published elsewhere in substantially similar content. All authors of a submitted manuscript must be made aware of and consent to the submission.

Publish Ahead of Print With OnlineFirst

OnlineFirst is a feature in which completed articles are published online prior to their inclusion in a print issue, offering authors the advantage of making their research accessible to the public in a more timely manner. Only online subscribers can view these PDFs, but abstracts are available to the public to view for free. Each OnlineFirst manuscript is citable by the publication date of the manuscript’s first online posting and the Digital Object Identifier (DOI), providing a persistent, permanent way to identify manuscripts published in the online environment. You can cite OnlineFirst articles as follows:

Author’s last name, first initials. Article title. Journal title. Pre-published month day, year; DOI: 10.1177/ 0123456789123456

Once your article has completed the production process and before it is published in a print issue, it will be posted online. You can access RSWP OnlineFirst articles on the Web at http://rswp.sagepub.com/pap.dtl . Once posted online, articles may not be retracted or edited. If your article is not completed prior to its publication date, it will not go on OnlineFirst but will be posted online with the issue in which it is published.

The journal uses a blind peer review system to evaluate manuscripts, and the expertise of the Editorial Board members is augmented by the extensive use of Guest Reviewers. Most authors receive an initial editorial decision within two months of submission, accompanied by constructive peer commentary. Most articles eventually accepted for publication undergo extensive author-completed revisions, based on peer-review commentary, prior to acceptance. The journal has a modest backlog of accepted manuscripts, thus authors of accepted manuscripts can expect a lag of about 12 months or less, from final acceptance to print publication. However, the journal has a publish-ahead-of-print service in that the final, corrected and accepted version of their paper will be published electronically on the journal’s website, with a ‘doi’. This will permit its ready access to the community of scholars, students, and practitioners months ahead of print publication. These articles will be both citable and downloadable. Articles are published in the general order of their acceptance.

Boutron, I., Ravaud, P. & Moher, D. (2012). Randomized clinical trials of nonpharmacological treatments. New York: CRC Press.

Campbell Collaboration. (2014). Campbell Collaboration systematic review: Policies and guidelines. The Campbell Collaboration. Available from www.campbellcollaboration.org

Fawcett, S. E., Waller, M. A., Miller, J. W., Schwieterman, M. A., Hazen, B. T., & Overstreet, R. E. (2014). A trail guide to publishing success: Tips on writing influential conceptual, qualitative, and survey sesearch. Journal of Business Logistics , 35 (1), 1-16.

Grant, S., Montgomery, P., Hopewell, S., Macdonald, G., Hoher, D. & Mayo-Wilson, E. (2013). Developing a reporting guideline for social and psychological intervention trials. Research on Social Work Practice, 23, 595-602.

Harrison, B. A. & Mayo-Wilson, E. (2014). Trial registration: Understanding and preventing

bias in social work research. Research on Social Work Practice, 24, 372-376.

Kratochwill, T. R., Hitchcock, J., Horner, R. H., Levin, J. R., Odom, S. L., Rindskopf, D. M. &

Shadish, W. R. (2010). Single-case designs technical documentation . Retrieved from What Works Clearinghouse website: http://ies.ed.gov/ncee/wwc/Document/229

Pratt, M. G. (2009). From the editors: For the lack of a boilerplate: Tips on writing up (and reviewing) qualitative research. Academy of Management Journal , 52 , 856-862.

Staller, K. M., & Krumer-Nevo, M. (2013). Successful qualitative articles: A tentative list of cautionary advice. Qualitative Social Work , 12 , 247-253.

Stewart, L., Moher, D. & Shekelle, P. (2012). Why prospective registration of systematic reviews makes sense. Systematic Reviews, 1 :7. doi:10.1186/2046-4053-1-7

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Literature Reviews in Social Work

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Literature Review

Literature reviews in social work tutorial.

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A literature review is a comprehensive summary of the ideas, issues, approaches, and research findings that have been published on a particular subject area or topic. However, it is not a simple description of all that the reviewer has read on the topic. It is better understood as a critical synthesis (or bringing together) of :

• What can reasonably be asserted based on the extent of the literature findings
• What worked and didn’t work in terms of methods of (and approaches to) investigation
• What can be gleaned from the range of theoretical perspectives that have been applied
• What gaps, inconsistencies or problems still need to be addressed in further research on the topic
• What results may reasonably be expected to be repeatable, and under what circumstances [1]

The review should be organized with a clear purpose and scope defined by the author of the review and should not be just a summary of existing research on the topic.

Literature reviews in social work increasingly focus on evidence-based research found in scholarly journals but there is some discussion within the profession that focusing only on evidence-based studies minimizes the importance of other sources of knowledge, including that gained through practical experience. Material published by think tanks, professional associations, and research institutes may provide valuable current information about a particular topic but they are often not peer-reviewed or evaluated for reliability and validity as is the case with research articles found in scholarly journals.

[1] Kiteley, Robin and Chris Stogdon.  Literature Reviews in Social Work . Sage, 2014

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The Current State of Evidence-Based Practice in Social Work: A Review of the Literature and Qualitative Analysis of Expert Interviews

While there is recent movement toward Evidence-Based Practice (EBP) in social work, criticisms subsist regarding the profession’s translation of research into viable practices. Evidence describing effective interventions exists, but research that addresses dissemination and implementation is generally lacking. This paper highlights existing literature on dissemination and explores the barriers, themes, and trends in EBP through eight expert interviews. The interviews reflect the issues described in the literature and provide additional insight to the process of implementation and dissemination of EBP. Findings from the literature and interviews are synthesized into research and practice recommendations.

While there is a call for Evidence-Based Practice (EBP) in social work and mental health services, there have also been a number of criticisms about the implementation of research findings into viable methods of practice. These barriers range from the egregious lag-time between research development to dissemination of evidence to practice settings to a veritable lack of support and training for community practitioners. There is a growing body of evidence describing effective interventions, but there is not a substantial body of work addressing the dissemination of these programs and other research findings for use in the field. This paper highlights some of the work around dissemination of EBPs in the field of social work with an emphasis on mental health services including an overview of the barriers to the use of evidence in practice and proposed models of conceptualization and implementation of EBP. To further highlight the current barriers, themes, and trends in EBP eight experts in the field of EBP were interviewed. The goal of the interviews was to survey the opinions of expert researchers in the area of EBP to supplement knowledge described in the literature. The experts’ responses reflected many of the same issues described in the literature as well as additional information regarding their efforts toward determining the most viable options to address the barriers to implementing and disseminating EBP. Findings from the literature review and interviews are synthesized into recommendations for future research and practice efforts.

INTRODUCTION

Practice decisions based on research evidence have increasingly become an identified need in the treatment of mental illnesses. Three of the most influential reports on mental health services policy in recent years, The President’s New Freedom Commission on Mental Health Report (2003) , The World Health Organization Report on Mental Health (2001) , and Mental Health: A report of the Surgeon General (1999), emphasize the need for research and evidence-based practices (EBPs) in mental health services. Even more broad health policy reports, such as Healthy People 2010 (2000) from the U.S. Department of Health and Human Services (DHHS), point to “an emphasis on translating new knowledge into clinical applications” in the mental health arena. The President’s New Freedom Commission on Mental Health (2003) recently released a final report calling for evidence based and recovery focused interventions in the treatment of mental illness; and the National Institute of Mental Health echoes this approach (Insel, 2003). Goal five of the President’s New Freedom Commission on Mental Health Report (2003) stresses the need to deliver excellent mental health care by accelerating research to promote recovery, resilience, prevention, and a cure for mental illness, advancing evidence-based practice dissemination and demonstration, expanding the workforce providing evidence-based practices, and developing a knowledge base in mental health disparities, long term medication effects, trauma, and acute care.

These national and international health and mental health reports are important to social work, not only as signposts of current trends in policy thought, but also as frameworks for future policy and funding activity. Federal agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA), Agency for Healthcare Research and Quality (AHRQ), and National Institute on Drug Abuse (NIDA) are beginning to link grants and contracts to EBP themes such as research-based interventions and the translation of research into practice as well as hosting conferences dedicated to EBP. These and other agencies are also outlining science-based program standards and rating systems. For example, the Center for Substance Abuse Prevention (CSAP) and SAMHSA recently constructed a comparison matrix of science based prevention programs examining the standards and effectiveness ratings of 150 different programs sponsored by five different federal agencies (2002).

According to Thomas Insel (2004) , director of the National Institute of Mental Health, social workers are doing the majority of front line work treating individuals with mental illnesses. Citing a 1998 SAMHSA report, the current psychotherapy workforce is dominated by social work consisting of 192,814 social workers, 73,014 psychologists, 33,486 psychiatrists, and 17,318 psychiatric nurses ( Insel, 2004 ). Despite social worker dominance in the field of mental health and the National Association of Social Workers (NASW) code of ethics emphasis on research based service, the majority of social workers do not appear to draw on research findings to inform their practice ( Gibbs & Gambrill, 2002 ; Kirk & Rosenblatt, 1981 ; Mullen & Bacon, 2004 ; NASW, 1996 ; Rosen, 1994 ). Social workers, including researchers, educators, agency administrators, and practitioners, are therefore challenged with an important question: “How can the profession better disseminate the rich and growing body of research and evidence based interventions in social work and mental health services to practitioners providing direct services to individuals with mental illnesses?” This paper contains a review of the current literature around the dissemination of EBP, current social work models for dissemination of EBP, interviews with experts in the field, and a synthesis of this combined knowledge into recommendations for future dissemination of research and EBP efforts.

LITERATURE SEARCH METHOD

For this project, research was conducted through a review of the literature, including both books and scholarly articles, on EBP in mental health services in social work as well as other relevant professions and by interviewing a convenience sample of experts currently conducting research related to the development and dissemination of evidence based interventions for mental illnesses. Relevant literature was identified through a search of local social work and public health library holdings and by searching electronically using the following databases: Social Work Abstracts, PsychLit, and Medline. Additional citations were collected via the reference lists of identified sources and through the draft reference list of EBP dissemination literature collected by the Research Unit for Research Utilization (RURU), a part of the Evidence Network of Great Britain ( RURU, 2003 ). This review was limited to published literature that directly describes the use of research in social work practice specifically.

LITERATURE REVIEW

The call for evidence-based practice.

The first widespread push for EBP in social work came out of a series of studies that began to appear in the 1970s and called into question the effectiveness of existing social work interventions ( Fisher, 1973 ; Reid, 1994 ). The 1970s and 1980s witnessed a movement to develop evidence based models of practice in mental health and further the development of well researched psychosocial intervention models such as the behavioral, cognitive, interpersonal, and social approaches, as well as the biological and biopsychosocial theories of mental illness ( Turnbull, 1991 ). Evidence-based researchers in many disciplines pioneered models used in social work practice including: psychology, psychiatry, and social work. In the late 1980s and early 1990s substantial evidence regarding the treatment of common mental health disorders were high-lighted by the publication of the results of studies such as the National Institute of Mental Health Treatment of Depression Collaborative Research Program ( Elkin, Shea, Watkins et al., 1989 ). Over the past decade, the proportion and number of articles referring to EBP published in professional journals has risen in the disciplines focused on mental health services, health, and social welfare ( Shlonsky & Gibbs, 2004 ). For a more detailed description of the history of the development and use of EBP in social work see Kirk and Reid (2002) .

Today, New York State’s Office of Mental Health, identified as a progressive program by NIMH (Insel, 2003), is promoting the use of the following EBP for adults with serious mental illnesses. These EBP interventions include: Assertive Community Treatment (ACT), supported employment, intensive case management, wellness self-management, family psychoeducation, integrated treatment for co-occurring substance abuse and mental health disorders, medication (and guidelines for practitioners to promote optimal prescribing practices), self-help and peer support services, and post-traumatic stress disorder (PTSD) treatment ( New York State Office of Mental Health, 2001 ). The President’s New Freedom Commission (2003) report identified the following additional EBPs for the treatment of mental health disorders: cognitive and interpersonal therapies for depression, preventive interventions for children at risk for serious emotional disturbances, treatment foster care, multi-systemic therapy (MST), parent-child interaction therapy, and collaborative treatment in primary care. The commission also recommended emerging best practices including: consumer operated services, jail diversion, and community re-entry programs, school mental health services, trauma-specific intervention, wraparound services, multi-family group therapies, and systems of care for children with serious emotional disturbances and their families ( New Freedom Commission, 2003 ).

Translation and Implementation

The wider field of social science knowledge utilization is just beginning to build a theoretical framework that explains why research evidence, such as the EBPs listed above, is or is not utilized in social work practice ( Landry, Amara, & Lamari, 2001 ). While researchers have identified evidence-based mental health services, the translation and implementation of these services into practice has been problematic. One of the greatest complaints has been the lag of nearly 15 to 20 years between the identification and incorporation of EBP interventions into routine care ( Balas & Boren, 2000 ). Moreover, social work is a profession that claims expertise and specialized knowledge, values, skills, and professional ethics aimed at addressing difficult human problems, including mental illness ( Gambrill, 1999 ); however, licenses, experiences, and training are not supported by evidence as necessarily related to helping clients through the use of evidence ( Dawes, 1994 ).

Gambrill (1999) describes two different strategies for addressing the problem that social work is a profession based on “claimed rather than demonstrated effectiveness” in assisting clients in obtaining targeted outcomes. The first strategy, and arguably the most common historically, has been to ignore the contradiction between claims and reality and to censure this information from the academic and practice community ( Gambrill, 1999 ). The second strategy is to investigate the values, skills, and knowledge needed to achieve certain outcomes and then to identify who has these resources and the capability to provide them ( Gambrill, 1999 ). Social workers can, in this way, become integral participants in the process of shaping and delivering supported and needed interventions for clients and communities.

Perhaps the most common subject described in the EBP literature has been the concrete and psychological barriers that impede dissemination and implementation of EBPs. These barriers, outlined by practitioners, researchers, and administrators alike, have generally revolved around four major themes: knowledge, lack of fit, suspicion, and resources.

Knowledge barriers are those that speak to the general lack of awareness of available EBPs and the difficulty in processing or understanding research findings when they are identified ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ; Mullen & Bacon, 2004 ). This Includes practitioners’ lack of knowledge about how to best access, critically evaluate, and translate evidence for appropriate use with their clients. Gray, one of the foremost thinkers in evidence based healthcare and policy, likens research-based facts to uncut diamonds, which are valuable but of little use in their raw form (1997). Few practitioners access traditional outlets for research findings, such as scholarly journals ( Kirk & Reid, 2002 ) and the information found in these journals is not easily digested or translated into practice ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ; Bartels, Haley, & Dums, 1998). Even when evidence is identified in journals, much journal evidence is three-to four-years-old by the time it is published ( Thyer, 2004 ). The lack of knowledge also includes arguments that are based on a misunderstanding of what constitutes an EBP. For example, some have argued that social work is already using and teaching EBP, that effectiveness is a matter of personal opinion, or that no clear evidence is available for the questions social workers pose ( Gibbs & Gambrill, 2002 ).

Even if practitioners are able to identify and understand research they may still discredit its value. The lack of fit theme includes the reasons why practitioners feel that available evidence or research is not often helpful. Some feel that the EBPs are cookbook approaches that are too broad and do not speak to the unique contextual or cultural needs of clients (Bartels, Haley, & Dums, 1998; Gibbs & Gambrill, 2002 ; Mullen & Bacon, 2004 ). Others have noted that the methodology of treatment may not be applicable within the confines of their practice. For example, many EBPs emphasize short-term treatment, but this format is not appropriate to all clients across diverse settings ( Mullen & Bacon, 2004 ). Moreover, practitioners have noted that research and current policy are often at odds. Research findings are slow to develop, and once findings are presented, it may take considerable time before policies are aligned with new knowledge. As a result, policy and agency requirements and technology frequently do not support current evidence ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ; Gibbs & Gambrill, 2002 ). Finally, the culture of knowledge transmission within social work has been historically unsupportive of the use of research evidence in practice ( Barratt, 2003 ).

Related to the idea of the lack of fit between research findings and practice is the theme of suspicion . This includes a basic distrust for evidence, based on objections related to political, ethical, or control issues. Gibbs sites a natural resistance to innovation (including EBPs) as one of the main barriers of teaching EBP to practitioners ( Gibbs, 2003 ). Some practitioners feel that research evidence is simply a cost-cutting tool, politically motivated, guided by efficiency, or otherwise influenced by something other than the client’s best interest ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ; Gibbs & Gambrill, 2002 ). Other practitioners feel the experts are more often guided by their own view or model rather than an objective examination of the evidence ( Barratt, 2003 ). Landry, Amara, and Lamari (2001) point oat that there is an inherent disconnect between the goals and needs of researchers and practitioners. Practitioners need and want guidance that is tailored to clients and practice. However, the degree to which research results are customized to only one or two users increase costs to the scholars. Their work becomes less generalizable to the wider world and they must reformat or repackage it if they want others to utilize their work. It becomes a catch-22 where researchers are pushed toward developing broad applications and their work becomes likewise less useful for the individual practitioner. Moreover, as Barnes and Clouder (2000) point out, the determination of what is disseminated is largely dependent upon the researcher’s judgment of what is significant or worth sharing. Others believe that EBPs exclude the practitioner’s professional judgment, clinical expertise, or the judgment, values and preferences of the client ( Gibbs & Gambrill, 2002 ; Mullen & Bacon, 2004 ). An argument has also been made that those who advocate EBP want only to set trends, be first, be controversial, or further their reputations and that evidence can be found to support any favored point of view or that all methods are equally valuable in arriving at the truth ( Gibbs & Gambrill, 2002 ). The idea that research is suspect seems also, in part, due to the generally poor relationship that researchers and scholars have had with community agencies and practitioners in the past. Administrators have described a lack of communication and a disjoint between the goals of the agency and that of researchers ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ; Barratt, 2003 ). Furthermore, practitioners’ may collaborate in creating or testing interventions with researchers, but their participation in building and sharing knowledge with the wider profession has generally been limited ( Kirk & Reid, 2002 ). The chasm between research and practice is further widened by practitioners’ inability to contribute to the formal body of social work knowledge that they are expected to employ. “Thus, knowledge production and dissemination is largely in the hands of a small number of academics, while expectations for use have often been placed on the vast number of practitioners” (p. 205, Kirk & Reid, 2002 ).

Even practitioners and agencies that understand, appreciate, and want to use research evidence in their work may find themselves incapable due to a lack of resources ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ; Barrett, 2003; Mullen & Bacon, 2004 ) and reluctance to ask more of an overextended staff ( Barratt, 2003 ). Without the necessary training, materials, time and staff dedication to researching the evidence, EBPs cannot often be employed. Interventions may be shaped instead by limitations rather than knowledge. A lack of technology is particularly troublesome in a day and age where most cutting-edge information is accessed through computers and the Internet. Many agencies do not have access to these resources. The issue is not only what resources are realistically available, but also beliefs or policies about who can have access to these resources. Some administrators feel that not all social workers should have access to computers and the Internet ( Barratt, 2003 ). The issue of a lack of resources is partly a result of generally poor or inconsistent funding for many social work agencies. However, funds that are available are rarely routed toward identifying, instituting and maintaining research, technology, or EBPs.

Growing Body of Evidence-Based Services and Programs and Arguments for Use

Despite the numerous barriers to dissemination outlined above, social workers in the mental health services arena do have a number of compelling reasons to implement evidence into their practice with mentally ill individuals. Practitioners have cited advantages of using EBPs such as: (1) conceptualizing, planning, and guiding treatment, (2) increasing knowledge and skills, (3) improving treatment outcomes for clients, (4) integrating and supplementing, not supplanting, clinical judgment and knowledge, (5) complying with current practice, values, and professional consensus, and (6) satisfying grant or managed care reimbursement requirements ( Mullen & Bacon, 2004 ). Overall, the basic tenet of EBPs is that clients should receive the benefit of the best technology that social work has to offer.

It is, however, difficult to imagine the basis on which structured, fact-based and well-informed decision making and planning referenced to the best available published research can be viewed as counter either to the provision of effective outcomes for service users, or to the ethos of the social work professional, (p. 144, Barratt, 2003 )

There are many questions as to what exactly should be used as evidence to identify the best technology possible. Undoubtedly this argument will, and should, continue within the field. However, if some agreement upon what is a validated intervention can be secured, the question becomes one of dissemination and implementation.

Current Strategies for Dissemination and Implementation

Until recently the prevailing approach to dissemination has been to report evidence in journal articles and published or unpublished practice manuals or to provide limited didactic trainings (Gibbs & Gambrill, 2003). Additionally, in recent years some masters programs have offered limited numbers of courses on some EBPs, such as cognitive behavioral therapy ( Gibbs & Gambrill, 2002 ). However, evidence suggests that these strategies have been largely unsuccessful in social work, as well as in the other professions treating individuals with mental health needs, as few mental health professionals are basing practice decisions on research evidence ( Gibbs & Gambrill, 2002 ; Kirk & Reid, 2002 ; Kirk & Rosenblatt, 1981 ; Mullen & Bacon, 2004 ; NASW, 1996 ; Rosen, 1994 ). To facilitate implementation of EBPs in the community, “… it is increasingly recognized that simply improving the content and availability of the evidence base is not sufficient to secure such changes. Explicit and active strategies are required to ensure that research really does have an impact on policy and practice” (p. 2, Walter, Nutley, & Davies, 2003 ). In order to flourish, efforts to implement evidence-based practices must be “multifaceted, broad-based and carefully targeted” (p. 144, Barratt, 2003 ).

Many researchers, program developers, and others have employed a cornucopia of what Walter, Nutley, and Davies (2003) term “mechanisms” to disseminate research findings. These authors reviewed over one hundred papers that evaluated or described efforts to facilitate the use of research. Nearly two hundred individual practices or packages were identified through this review. Based on these, the authors developed a taxonomy of approaches by both intervention type (format through which the information flows) and mechanisms employed, as well as a brief description of the research or theory that lends support to the specific approach. For example, one category of mechanisms described by the authors is incentives. The adoption of desired behaviors or information is encouraged through reward, or perhaps linking funding to specific practices. This mechanism is supported by learning theories, economic models of rational behavior, and power theory. Using such taxonomy to organize and understand dissemination research could potentially prove useful.

A number of researchers have taken the process a step further than individual mechanisms or approaches and proposed more developed frameworks for the delivery of research evidence into practice. While no single best method has been identified, there are a number of emerging social work implementation strategies described in the literature. The following is a brief overview of this work.

Anderson and colleagues

Based on interviews with community organization leaders, Anderson and colleagues suggest a model based on a relationship between researchers and community organizations that moves through three different stages. In the first stage, awareness , both researchers and community organizations are educated about the needs of one another ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ). In many cases both researchers and community-based organizations have little contact and are generally ignorant of the other’s work. In the second stage, communication , mechanisms are built to facilitate the transfer of information. Both community organizations and research stakeholders come together to formulate a plan for sharing skills and knowledge. A variety of methods may be employed such as: workshops, databases, and open houses. Finally, in the last stage, interaction , mutual activities toward common goals are shared and negotiated. In this model, a relationship is built to facilitate communication and knowledge transfer between community organizations and researchers allowing each to inform the other’s work. This model is general, offers some specific recommendations, but seems to focus largely on encouraging local groups to work together in order to find the methods that match their shared needs, abilities, and resources.

Gambrill and Gibbs

Leonard Gibbs and Eileen Gambrill propose a model defining EBP as the ‘conscientious, explicit, and judicious use of current best evidence to make decisions about the care of clients’ ( Gibbs & Gambrill, 2002 ). The aim of their model is to create lifelong learners who, in collaboration with clients, draw on practice related research findings to make practice related decisions ( Gibbs & Gambrill, 2002 ). In this model, EBP is a process that results from the careful consideration of practitioner’s individual experience, best available evidence, and client values and expectations ( Shlonsky & Gibbs, 2004 ). EBP is characterized by: (1) becoming motivated to apply evidence to practice decision making, (2) an individual assessment and well formulated question, (3) an external electronic search for practice findings related to practice questions, (4) decision-making regarding the evidence’s fit with the individual client, (5) using individual expertise to integrate the best external practice evidence, (6) evaluating the outcome (7) and sharing what is learned with others ( Gibbs, 2003 ; Gibbs & Gambrill, 2002 ). These authors propose a method of dissemination heavily focused on the education of practitioners in this model of EBP at the master’s level ( Gibbs, 2003 ; Gibbs & Gambrill, 2002 ).

Outside of the implementation of EBP as core curricula in master’s level social work programs and continuing education, Gibbs and Gambrill offer little advice on implementation suggesting that practitioner’s ‘obey your own conscience and implement EBP into your own practice however you feel it most appropriate to do so’ ( Gibbs, 2003 ). The following suggestions are offered, (1) consider the quality and applicability of evidence, (2) consider the context or organizational environment, and (3) consider the process of implementing change ( Gibbs, 2003 ). However, a clear design for implementation, outside of teaching, master’s level education, and continuing education, is not offered.

Rosen and Proctor

Aaron Rosen and Enola Proctor have devised an implementation strategy that relieves the practitioner of the burden of formulating and identifying the relevant research, locating, and assembling the information, critically evaluating the relevancy and validity of the evidence with regard to their practice decisions with an individual client, and adapting that knowledge to the client’s particular needs and situation ( Rosen, Proctor, Morrow-Howell, Auslander, & Staudt, 1993 ). The strategy proposed involves the use of Systematic Planned Practice (SPP), a tool for treatment planning and evaluation that includes the planning and recording of critical elements of practice such as the presenting problem(s), desired outcomes, interventions, and observed results ( Rosen et al., 1993 ). Application is guided by forms that serve two functions: to prompt and guide the worker in laying out the treatment plan and as a rationale for decisions made and to provide documentation for treatment planning decisions, what is actually implemented, and the outcomes obtained ( Rosen et al., 1993 ). A dissemination plan is proposed that combines SPP with components of practice guidelines to facilitate practitioner use and knowledge of evidence in practice (Rosen, 2002). According to Proctor, the adoption of EBP consists of multiple distinct outcomes whose attainment requires “systematic, targeted efforts by many players, at multiple levels of influence” ( Proctor, in press ). These include the following provider outcomes necessary for evidence based practice; identifying and accessing EBPs, accepting and adopting EBPs, implementing EBPs and evaluating EBPs (Proctor, 2004). As in the Gambrill and Gibbs model, Rosen and Proctor place much of the burden of utilization on the practitioner to locate and implement research knowledge. While Anderson and colleagues frame the process as more of a partnership between researchers and practitioners, it lacks specificity in terms of implementation.

Tool Kit Method

Another approach to the dissemination of EBPs is the tool kit method. Tool kits are materials constructed from original research and translated for use by practitioners, agencies, or institutions. In this model, specific tools rather than a framework or mandate are provided to support social workers’ efforts toward using EBPs. Resources, such as the Sociometrics Program Archives, have taken up the business of culling through research with the help of expert panels to develop a collection of tools such as: user’s guides, teacher or facilitator manuals, student or participant workbooks, videos or other supplemental media, and homework or exercises ( Card, 2001 ). Practitioners can order such tool kits from for profit and nonprofit enterprises at a cost. The idea is that the necessary research evidence is distilled into an attractive user-friendly format that is ready for implementation in the community. Evaluation processes are also sometimes included to provide a conduit for user feedback and further refinement of the toolkit package ( Card, 2001 ).

Practice Guidelines

Instituting practice guidelines, which have often been employed in using practice theory and wisdom since the beginning of the profession, has been another method recommended for the dissemination of EBPs ( Kirk & Reid, 2002 ). Using this format, treatment is directed by an outline of acceptable practices in specific areas of treatment. These practices would be determined by a professional body-charged with surveying, evaluating, and choosing both prescribed and proscribed interventions. Researchers have made arguments against such guidelines including: (1) the paucity of research needed to support good guidelines, (2) the lack of agreement on what constitutes evidence, (3) too little flexibility for practitioners, (4) little agency support, (5) and the fear of the use of guidelines as de facto standards in litigation against practitioners (Howard & Jensen, 1999). Despite these objections, Howard and Jensen (1999) argue that practice guidelines can go a long way toward improving social work interventions (for an excellent discussion of the potential problems and benefits of practice guidelines in social work please see the May 1999 issue of the journal Research on Social Work Practice ).

Other models

Historically other models have been explored to marry research and practice. Kirk and Reid (2002) describe efforts that grew out of industry and technology beginning in the 1960s and 70s such as the Research Development and Diffusion (RD&R) and Design and Development (D&D) models. These models describe a paradigm by which research and practice can be mutually informative in a constant feedback loop. However, as Kirk and Reid point out, these efforts would be enhanced if they were to be exposed to the same processes that they propose in order to become more flexible and useful across diverse social work contexts.

General recommendations

Beyond the more developed models described above, several researchers have made general recommendations for dissemination of evidence into practice. First, it is essential to secure organizational and practitioner buy-in ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ; Lewis, 1998 ; Mullen, 2004 ). Before any real progress is made toward dissemination stakeholders must both agree that EBP is valuable and important enough to merit a commitment of time, training, and other resources. Leadership is a crucial ingredient for change in this area ( Barratt, 2003 ). Although the dissemination of EBPs must occur at all levels, important issues such as protecting practitioner time for research and training as well monitoring and following up on implementation activities must be guided by administrators and other persons or agencies with authority. Also, some authors have described the importance of establishing a network of local organizations and practitioners so that they can pool resources such as training and research, become actively involved, and develop broad community goals ( Anderson, Cosby, Swan, Moore, & Broekhoven, 1999 ; Howard & Jensen, 1999). McKay and colleagues stress the importance of training and the establishment of an “engagement team” consisting of intake workers, clinical and administrative staff, and supervisors who oversee the implementation of interventions at each site ( McKay, Hibbert, Hoagwood, Rodriguez, Murray, Legerski, & Fernandez, 2004 ). Agencies and practitioners cannot be realistically expected to “go it alone” on tight budgets, timelines, and a research base that is a moving target. A much more efficient approach seems to be one of networking and sharing with other social workers, community organizations, educational institutions, and other stakeholders.

Unfortunately, the authors found few studies testing the efficacy of these approaches to the dissemination and utilization of research in practice. In essence, the research evidence on the use of EBPs has not been well developed. “Researchers have been relatively oblivious to the processes by which knowledge, once developed, might be effectively disseminated and used” ( Kirk & Reid, 2002 ).

QUALITATIVE INTERVIEWS

Based on themes identified in the literature review, the authors conducted qualitative interviews with experts in the field of EBP. The goal of the interviews was to survey expert researchers in order to explore current strategies, struggles, and observations about EBP to supplement and speak to the themes described in the literature.

Interviews with expert researchers experienced in mental health services research and evidence-based clinical interventions were conducted using open ended questions related to the topic of the dissemination and implementation of evidence based practices. Because this research is exploratory in nature, a convenience sample of interview candidates was selected on the basis of reputation and body of work in the field of EBP. In addition, a snowball method of interviewee selection was employed where respondents referred the authors to other experts for further data collection. All participants were researchers trained at the doctoral level. In total eight experts were interviewed including: five social worker professors, one professor of psychiatric epidemiology, one psychiatrist who directs a children’s mental health research program, and one national policy organization researcher.

Human Subjects Protections

Each potential respondent was invited to share thoughts and opinions regarding the use of EBP in mental health services and was provided a copy of the questions before the interview. Interviews were voluntary and the experts were not compensated for participating. Any identifying information regarding the individual interviewees was not included in the analysis and confidential interviews were maintained on password-protected computers in a locked office. Participants were given copies of the data collected in order to edit or make any additions to their responses.

Interview Schedule

The three authors interviewed all of the participants in the participants’ offices. For six of the eight interviews all three authors were present. For two of the interviews, only two authors were present. Each author took detailed notes during the interview highlighting major themes. Participants were provided with the following list of questions prior to the interview:

• What is your experience with Evidence Based Practice (EBP)?
• Have you done research around topics of EBP?
• What do you see as the barriers to implementing EBP in practice settings?
• What means of disseminating EBP have you seen employed?
• What are some of your ideas about how to improve the dissemination of EBP?
• Why do you think more practitioners don’t use EBP?
• What are the results of not using EBP?
• Where do you see gaps in EBP?
• How would you characterize the future of EBP?
• Do you know of any existing models or tools for the implementation of EBP? What are your thoughts about their usefulness?

Transcription

Authors took notes to highlight major themes in the interviews from each respondent. Following the interviews, the authors compiled notes for content analysis. To ensure inter-rater reliability the three interviewers transcribed all interviews separately. Transcription reports were compiled into one report for each participant to generate the most accurate representation of their comments.

Content analysis was conducted for each interview. Krippendorf (1980) defines content analysis as “a research technique for making replicable and valid inferences from data to their context” (p. 21). Janis (1965) defines it as:

Any technique (a) for the classification of the sign-vehicles (words that carry meaning), (b) which relies solely upon the judgment (which theoretically may range from perceptual discrimination to sheer guesses) of an analyst or group of analysts as to which sign-vehicles fall into which categories, (c) provided that the analyst’s judgments are regarded as the report of a scientific observer, (p. 55)

For the purpose of this analysis, semantical content analysis was conducted to classify sign-vehicles according to their meanings. The interviewers reviewed protocols for three types of semantical content analysis; designations analysis , which determines the frequency with which certain objects are mentioned, attribution analysis , which examines the frequency with which certain characterizations or descriptors are used, assertions analysis , which provides the frequency with which certain objects are characterized in particular ways. Assertions analysis involves combining designation analysis and attribution analysis. Such an analysis often takes the form of a matrix, with objects as columns and descriptors as rows.

Because assertions analysis is the most comprehensive form of semantical analysis, the authors employed this method of examination. Past experience with EBP, levels of dissemination, barriers to dissemination, gaps in dissemination, methods of addressing barriers, results of not using EBP, and the future of EBP were designated as objects and 70 items were designated as descriptors.

Past Experience with EBP

The majority of participants had experience with EBP program design including; running an intervention, evaluating the effectiveness of interventions, the process of forensic evaluation of children referred for sexual abuse, adapting interventions, and coordinating advocacy, policy, technical assistance, and research synthesis efforts at the state level. Beyond program design, participants had developed evidence based interventions, taught EBP in the classroom, and developed tool kit models of EBP.

Levels of Dissemination

The experts had experience with tool kits, literature, and training as methods of disseminating evidence based practice. Inclusion of practitioners in design, developing programs in the communities where they will be implemented, state and agency dissemination, norm changing, appropriate targeting of stakeholders, Requests for Proposals (RFPs) for models, supervision, national networks, quality assurance, and masters education programs were mentioned as means of dissemination they have seen employed. One interviewee said that when evidence based practices are disseminated and implemented they look like “rocket science” in comparison to standard care because standard care is so poor. However, as one expert stated, “there is a lot more ‘talk’ about EBP than actual implementation.”

Interviewees mentioned training time and funding policies as the biggest barriers to implementing EBP. They cited lack of consumer input, lack of practitioner input, lack of translation research, and lack of EBP training in master’s level education as barriers. For example, one expert described how clients may not like interventions based on EBP because practitioners who employ EBPs tend to approach treatment as if they are the experts. However, practitioners need to use EBP and remain open to the idea that the consumer has something to teach.

A lack of practitioner involvement, testing EBP in research labs, limited provider skills, training time, and belief that EBP is too restrictive were each described by the experts as problems. “Most agencies are reactive and just trying to get by. EBP isn’t part of the culture.” Also mentioned were dissent among stakeholders, a lack of education across systems, lack of agency staff, misunderstanding of what EBP is, and professors who do not apply their EBP research to their teaching as ultimate barriers to implementing EBP.

There was less variation in responses to gaps in implementing EBP than in respondents’ description of barriers to implementation. Experts mentioned both the limited research of EBPs and unclear methods of training in EBP as gaps in the system of dissemination. Also cited was a lack of consumer input and the limited number of EBPs, a reluctance to over generalize interventions, and the difficulty of transferring programs from research into practice as limitations. Respondents claimed that lack of education and training in EBP were major problems that keep EBP from being disseminated and implemented in the practice community. One respondent suggested:

The language is off when we talk about dissemination. There is an assumption that development happens in one place and then it is rolled out elsewhere. You can get into trouble with this. You need to include practitioners and support staff. How do they integrate services? Roll-out is rejected by providers because there is no ownership. You need key constituents to sit around the table and create something that will fit–knowledge about practice outside of practice. You have to get practitioners invested in the process of adaptation. Without early involvement of administrators and practitioners, the treatment will not be sustained after the researcher leaves the setting.

Addressing Barriers

To address barriers the respondents recommended ongoing training, EBP in master’s level curriculum, stakeholder buy-in and consumer buy-in. For example, the Gibbs model that incorporates EBP, client preference, and practitioner expertise allows enough flexibility for all parties to feel invested in the intervention. Manualized treatments and beginning research in agencies, as well as tool kits, technical assistance on site, and systemization were identified as effective strategies to overcome the hurdles of disseminating and implementing EBP. According to some of the experts interviewed, state involvement in EBP curriculum for universities has proven to be a good method to address the barriers for disseminating EBPs.

Results of Not Using EBP

Research experts agreed that interventions may not be helpful, and may even be harmful, if they are not backed by research evidence. Some felt that in the future agencies will not be reimbursed if they fail to practice from an evidence base and the field of social work will fail to progress in the absence of EBPs. Social work will continue to be viewed as a second-class citizen in comparison to other professions that are more willing to embrace research evidence.

Respondents offered diverse views of the future of EBP. Some respondents stated that there will be more funding for EBP in the future. On the other hand, other respondents felt that EBP is a buzz term that will probably die out with time. The experts interviewed described the future of EBP moving toward more qualitative methods, training in EBP at the master’s level, incorporation of the art of clinical practice, diverse EBP models, well-developed research on EBP, studies in actual practice settings, and more sophisticated and informed implementation and dissemination efforts.

Strengths, Limitations, and Recommendations

This analysis is limited due to its sample size as well as by the lack of variation of professional affiliation. However, it does provide a starting point for future analysis. It is clear that experts in the field are indeed aware of the gaps and barriers to EBP dissemination. Future efforts would benefit from the incorporation of larger and more varied interview samples that include researchers and educators as well as agency administrators, direct service providers, and consumers of mental health and social work services. Additionally, future researchers should focus their attention on addressing barriers to dissemination and on the opinions and recommendations of other mental health services stake-holders such as clients, community members, and policy makers. Future EBP research needs to focus greater attention on strategies of effectively disseminating the programs that constitute the best practice standards.

The original aim of this study was to build a framework for the dissemination of evidence based mental health practices for social workers in community agencies through a review of the literature and interviews with experts in the field. Both the literature reviewed and the respondents offer similar observations and themes regarding EBP. The greatest agreement between the different researchers was found in the description of gaps and barriers to implementing and disseminating EBP. Problems include poor funding, a lack of training and support for agency staff and practitioners, a lack of consumer involvement, a failure to translate research into practice, and a lack of EBP education, particularly at the master’s level. Interviewees also described efforts to identify the most viable options to address barriers to implementing and disseminating. They, along with other researchers, have identified needs that must be addressed to move EBP forward. If social work does not meet these challenges, practitioners, and community organizations will not be best serving clients and will be in danger of losing competitive funding for services.

Some of the misconceptions about EBPs must be addressed in order to facilitate dissemination and implementation of evidence based interventions. EBPs are not promoted by the experts interviewed in this study as the final draft of best practices for mental health services. Rather, they are being promoted as efficacious treatments for specific disorders in certain populations of individuals suffering from mental illnesses. While further testing is needed to validate findings regarding EBPs for additional mental health disorders and different cultural groups, the information currently available regarding EBPs may be a best beginning practices guide in treatment planning for individuals with mental illnesses. Empirically validated EBPs are not recommended as a ‘magic bullet’ for the treatment of all mental illnesses. Research has, and continues to, explore the populations and disorders that are responding to specific EBPs, develop approaches to the flexible and practical employment of EBPs, and acknowledge that it is equally important to understand when the utilization of EBPs in treatment planning is or is not indicated.

IMPLICATIONS

Perhaps the most important finding of this study with regard to future research is the paucity of studies testing and validating implementation and dissemination strategies. No such studies have been conducted in social work (Gibbs, 2002). This research is needed to meet the growing demand for practitioners to base decisions on evidence. Researchers must also face the challenge of developing collaborative relationships with agencies, practitioners, communities, and clients. If research is not tailored to the questions posed by these stakeholders as well as researchers, the likelihood of its implementation into everyday practice is greatly decreased. The challenge to researchers in academic settings has the added component of focusing on incorporating research on EBPs into teaching curriculum.

Any successful effort toward the dissemination of EBP will have to address the four areas of barriers described in the literature and by respondents: knowledge, lack of fit, suspicion, and resources. Efforts that are not active and multifaceted seem unlikely to succeed. Organizational, practitioner, community, and client buy-in are also essential to a well-formed dissemination approach. Leadership backed by the power to effect change will be crucial. It takes more than an individual practitioner, agency, or educational institution to effect a cultural change within social work mental health services.

Existing frameworks offer a step in the right direction. However, they do not appear to provide a comprehensive and united approach to improving the dissemination of EBPs. Anderson and colleagues’ framework highlights the importance of developing shared goals between community organizations and researchers to combat problems inherent in poor relationships and communication and thus has the potential for impacting all four barriers by increasing coordination, understanding, and efficiency. However, this framework seems overly general. More detailed solutions would assist researchers and community organizations in efforts toward translating research into practice and constructing common goals. Additionally, the question of leadership is not addressed. Forging networks and consensus building can take a heroic effort and consume a considerable amount of time and energy. Strong leadership is needed to catalyze this process of change. Gibbs and Gambrill similarly offer useful approaches, such as involving social work education in the process of change and helping individual workers to be flexible and skilled in processing and applying new research. However, a large burden is placed on the practitioner and the problem of resources in particular is not addressed. Many social workers do not have the time or access to needed resources such as the internet. Rosen and Proctor’s model is more specific than either Anderson and colleagues or Gibbs and Gambrill, however they do not offer solutions to the problems of resources, translation of research into practice, or needed professional and cultural buy-in. While the industry-inspired D&D models offers important insights into how researchers might form a feedback loop with practitioners in the field to form more user-friendly tools, these approach seems limited in its application, particularly in the absence of a sophisticated infrastructure to support activities. General methods such as toolkits and practice guidelines are potentially useful strategies, and may supplement any of the other models. While each framework offers important insights into the best approaches toward the dissemination of EBP, none stands alone or above the rest.

CONCLUSIONS

To encourage practitioners to implement EBPs a unified approach that incorporates the best of all of the strategies outlined above and addresses the major barriers identified in this paper:

• Increase EBP education (particularly at the master’s level) as well as access to high quality continuing education based on EBPs.
• Build partnerships toward sharing EBP resources, including technology, training, and technical assistance, between agencies and practitioners.
• Facilitate buy-in and ownership of EBPs at all levels of stakeholders including practitioners, administrators, researchers, policy makers, and community members.
• Translate research into user-friendly, digestible, and specific approaches, providing tools such as tool kits, guidelines, and technical support to both support and encourage the use of EBPs.
• Improve the communication, feedback loop and relationship between researchers and practitioners.
• Increase the number of EBPs available to the field.
• Test the different types and mechanisms of dissemination, perhaps through analyses based on a taxonomic framework like the one proposed by Walter, Nutley, and Davies, to organize future research efforts.

The most important factor in facilitating change toward the use of research in professional practice is whether or not the profession wants to change ( Naylor, 1995 ). As the call for EBP in mental health services grows, social workers will benefit by being more research-minded and thereby improve services for their clients. The call for the use of research evidence in practice is not limited to a trend of policy, but is also aligned with the professional code of ethics ( NASW, 1996 ) and meeting the expectations of an increasingly savvy consumer movement in mental health ( Mowbray & Holter, 2002 ). Major national reports, which often shape federal and private funding streams, continually call for the use of research-supported interventions. However, policies that encourage, if not require, the use of EBPs cannot succeed without adequate training, resources, technical assistance and other infrastructure support necessary to deliver evidence based mental health interventions, Even if social workers endorse the value of EBP, practitioners and administrators may not have the knowledge or the resources to implement research based practices. The search for research evidence alone is difficult, and the more complicated the decision the less available the evidence ( Gray, 1997 ). Additional demonstration projects, and research and policy efforts aimed at moving EBPs into community-based organizations there-by building professional and organizational capacity are needed to address these and other barriers. Social workers are poised to move this work forward by transferring the increasingly broad and sophisticated body of research mindfully into the hands of the community agencies and practitioners.

Acknowledgments

The authors would like to thank Edward J. Mullen and Sandra Nutley for their assistance with this project. In addition, the contributions of all experts interviewed for this project are gratefully acknowledged.

This work was supported by the National Institute of Mental Health Grant 5T32-MH014623-24.

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This work was presented at the AcademyHealth 2004 Annual Research Meeting, San Diego, CA; the National Service Research Award (NSRA) Trainee Conference, San Diego, CA; and the Fourth International Conference on Social Work in Health and Mental Health, Quebec City, Quebec, Canada.

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• Anderson M, Cosby J, Swan B, Moore H, Broekhoven M. The use of research in local health service agencies. Social Science & Medicine. 1999; 49 :1007–1019. [ PubMed ] [ Google Scholar ]
• Balas EA, Boren SA. Yearbook of Medical Informatics 2000. Bethesda, MD: National Institute of Mental Health; 2000. Managing clinical knowledge for health care improvement. [ PubMed ] [ Google Scholar ]
• Barnes V, Clouder L. Dissemination as evidence? Deconstructing the processes of disseminating qualitative research. Symposium presented at the Qualitative Evidence-based Practice Conference, Coventry University; Coventry, England. 2000. [ Google Scholar ]
• Barratt M. Organizational support for evidence-based practice within child and family social work: A collaborative study. Child and Family Social Work. 2003; 8 :143–150. [ Google Scholar ]
• Bartels SJ, Haley WE, Dums AR. Implementing evidence-based practices in geriatric mental health. Generations. 2002; 26 (1):90–98. [ Google Scholar ]
• Card J. The sociometrics program archives: Promoting the dissemination of evidence-based practice through replication kits. Research on Social Work Practice. 2001; 11 (4):521–526. [ Google Scholar ]
• Comparison Matrix for Science Based intervention Programs: A Consumer’s Guide for Prevention Professionals. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2002. Center for Substance Abuse Prevention. http://modelprograms.samhsa.gov/pdfs/ComparisonMatrix.pdf .
• Dawes RM. House of cards: Psychology and psychotherapy built on myth. New York: Free Press; 1994. [ Google Scholar ]
• Elkin I, Shea T, Watkins JT, Imber SD, Sotsky SM, Collins JF, Glass DR, Pilkonis PA, Leber WR, Doherty JP, Fiester SJ, Parloff MB. National Institute of Mental Health Treatment of Depression Collaborative Research Program: General effectiveness of treatments. Archives of General Psychiatry. 1989; 46 :971–982. [ PubMed ] [ Google Scholar ]
• Fisher J. Is casework effective? A review. Social Work. 1973:5–20. [ Google Scholar ]
• Gambrill E. Evidence-based practice: An alternative to authority-based practice. Families in Society. 1999; 80 :341–350. [ Google Scholar ]
• Gibbs LE. Evidence-Based Practice for the Helping Professions: A Practical Guide to Integrated Multimedia. Pacific Grove, CA: Brooks/Cole; 2003. [ Google Scholar ]
• Gibbs LE, Gambrill E. Evidence-based practice: Counterarguments to objections. Research on Social Work Practice. 2002; 12 :452–476. [ Google Scholar ]
• Gray JAM. Evidence-Based Health Care. New York: Churchill Livingstone; 1997. [ Google Scholar ]
• Insel T. Science to service: Mental health care after the decade of the brain. Presentation given at Society for Social Work Research Annual Conference; New Orleans, LA. 2004. Jan 16, [ Google Scholar ]
• Kirk S, Rosenblatt A. Research knowledge and orientation among social work students. In: Briar S, Weissman H, Rubin A, editors. Research Utilization in Social Work Education. New York: Council on Social Work Education; 1981. pp. 29–35. [ Google Scholar ]
• Kirk SA, Reid WJ. Science and Social Work: A critical appraisal. New-York: Columbia University Press; 2002. [ Google Scholar ]
• Landry R, Amara N, Lamari M. Climbing the ladder of research utilization. Science Communication. 2001; 22 (4):396–422. [ Google Scholar ]
• Lewis J. Building on evidence-based approach to social interventions. Children & Society. 1998; 12 :136–140. [ Google Scholar ]
• McKay MM, Hibbert R, Hoagwood K, Rodriquez L, Murray L, Legerski J, Fernandez D. Integrating evidence-based engagement interventions into “real world” child mental health settings. Brief Treatment and Crisis Intervention. 2004; 4 :177–186. [ Google Scholar ]
• Mowbray CT, Holter MC. Mental health and mental illness: Out of the closet? Social Service Review. 2002; 76 :135–179. [ Google Scholar ]
• Mullen EJ. Facilitating practitioner use of evidence-based practice. In: Roberts AR, Yeager K, editors. Evidence-Based Practice Manual: Research and Outcome Measures in Health and Human Services. New York, NY: Oxford University Press; 2004. [ Google Scholar ]
• Mullen EJ, Bacon W. A survey of practitioner adoption and implementation of practice guidelines and evidence-based treatments. In: Roberts AR, Yeager K, editors. Evidence-Based Practice Manual: Research and Outcome Measures in Health and Human Services. New York, NY: Oxford University Press; 2004. [ Google Scholar ]
• National Association of Social Workers. Code of Ethics. Washington, DC: Author; 1996. [ Google Scholar ]
• Naylor CD. The grey zones of clinical practice: Some limits to evidence-based medicine. Lancet. 1995; 345 (8953):840–842. [ PubMed ] [ Google Scholar ]
• New Freedom Commission on Mental Health. Rockville, MD: United States Department of Health and Human Services; 2003. Achieving the Promise: Transforming Mental Health Care in America. Final Report. (No. DHHS Pub. No. SMA-03-3832) http://www.mentalhealthcommission.gov/reports/FinalReport/downloads/downloads.html .
• New York State Office of Mental Health. Winds of Change: Creating an Environment of Quality. Albany, NY: New York State Office of Mental Health; 2001. [ Google Scholar ]
• Proctor EK. Leverage points for the implementation of evidence-based practice. Brief Treatment and Crisis Intervention. (in press) [ Google Scholar ]
• Reid WJ. The empirical practice movement. Social Service Review. 1994 June;:165–184. [ Google Scholar ]
• Research Unit for Research Utilization (RURU) Research Unit for Research Utilization draft website database. 2003. http://www.st-andrews.ac.uk/~ruru/
• Rosen A. Knowledge use in direct practice. Social Service Review. 1994; 68 :561–577. [ Google Scholar ]
• Rosen A, Proctor EK, Morrow-Howell N, Auslander WE, Staudt M. Systematic Planned Practice: A Tool for Planning, Implementation, and Evaluation. 1993 Unpublished Manual. [ Google Scholar ]
• Shlonsky A, Gibbs L. Will the real evidence-based practice please stand up? Teaching process of evidence-based practice to helping professions. Brief Treatment and Crisis Intervention. 2004; 4 :137–153. [ Google Scholar ]
• Thyer BA. What is evidence based practice? Brief Treatment and Crisis Intervention. 2004; 4 :167–176. [ Google Scholar ]
• Turnbull JE. Depression. In: Gitterman A, editor. Handbook of social work practice with vulnerable populations. New York: Columbia University Press; 1991. pp. 165–204. [ Google Scholar ]
• U.S. Department of Health and Human Services. Healthy People 2010. 2nd Ed. Washington, DC: U.S. Government Printing Office; 2000. http://www.healthypeople.gov/Document/tableofcontents.htm#tracking .
• U.S. Department of Health and Human Services. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health; 1999. Mental Health: A Report of the Surgeon General. http://www.surgeongeneral.gov/library/mentalhealth/home.html .
• U.S. Department of Health and Human Services. Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. Substance Abuse and Mental Health Services Administration; 2001. http://www.surgeongeneral.gov/library/mentalhealth/cre/
• Walter I, Nutley S, Davies H. Developing a taxonomy of interventions used to increase the impact of research. Fife, Scotland: Research Unit for Research Utilization, University of St. Andrews; 2003. [ Google Scholar ]
• World Health Organization. The world health report: 2001: Mental health: New understandings, new hope. Geneva, Switzerland: World Health Organization; 2001.

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Literature Review Overview

NCSU. (n.d.). “Literature Reviews: An Overview for Graduate Students.” [YouTube]. Retrieved from https://youtu.be/t2d7y_r65HU

What is a literature review?

A literature review is a systematic review of the published literature on a specific topic or research question.  The literature review is designed to analyze-- not just summarize-- scholarly writings that are related directly to your research question.  That is, it represents the literature that provides background information on your topic and shows a correspondence between those writings and your research question.

University of Pittsburgh. (n.d.).  Retrieved from  http://pitt.libguides.com/c.php?g=210872&p=1391698

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Planning your literature review

Planning your literature review.

Writing a literature review will take time to gather and analyze the research relevant to your topic, so it best to start early and give yourself enough time to gather and analyze your sources.  The process of writing a literature review usually covers the following steps:

• Define your Research question
• Plan your approach to your research and your review
• Search the Literature
• Analyze the material you’ve found
• Manage the results of your research
• Write your Review

Defining Your Research Question

One of the hardest parts of a literature review is developing a good research question.  You don't want a research question that is so broad it encompasses too many research areas and can't be reasonably answered. 

Defining your topic may require an initial review of literature to get a sense of the scope about your topic.   Select a topic of interest, and do a preliminary search to see what kinds of research is being done and what is trending in that area.  This will give you a better sense of the subject and help you focus your research question.

In specifying your topic or research question, you should think about setting appropriate limitations on the research you are seeking. Limiting, for example, by time, personnel, gender, age, location, nationality etc. results in a more focused and meaningful topic. 

Using an example from the Duke University Writing Studio, you may start with a general question: 

Why did the chicken cross the road ?  This question is so general that you could be gathering relevant research for days. 

A more precise research question might be: 

What are some of the environmental factors that occurred in New York City between November and December 2017 that would cause a chicken to cross Amsterdam Avenue at 185th Street?   This research question is specific about a number of variables like time, geography, etc.

Common Mistakes to Avoid

These are the most common mistakes made in reviewing social science research literature:

• Sources in your literature review do not clearly relate to the research problem
• You do not take sufficient time to define and identify the most relevant sources to use in the literature review related to the research problem
• Relying exclusively on secondary analytical sources rather than including relevant primary research studies or data
• Uncritically accepting another researcher's findings and interpretations as valid, rather than examining critically all aspects of the research design and analysis
• Not describing the search procedures that were used in identifying the literature to review
• Reporting isolated statistical results rather than synthesizing them in chi-squared or meta-analytic methods
• Only includes research that validates assumptions and not considering contrary findings and alternative interpretations found in the literature

USC. (n.d.). Retrieved from  http://libguides.usc.edu/writingguide/literaturereview

• When working on a literature review, it's a good idea to save your research in a citation manager such as RefWorks or Zotero.
• If a book or article is not available in the YU Libraries, it can be ordered through Interlibrary Loan.  You should never need to pay for your information.
• The Dissertations & Theses Global database is a good place to start.  You will see what research has already been done on your topic.
• For more detailed information, see below:
• Systematic Literature Searching in Social Work: A Practical Guide with Database Appraisal
• Writing Integrative Literature Reviews: Guidelines and Examples
• Literature Reviews (From UNC College of Arts & Sciences)
• The Literature Review: a Few Tips on Conducting It
• Conducting a Literature Review: A Brief Interactive Tutorial

Books on Literature Review

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Rigor in Qualitative Social Work Research: A Review of Strategies Used in Published Articles

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Amanda Barusch, Christina Gringeri, Molly George, Rigor in Qualitative Social Work Research: A Review of Strategies Used in Published Articles, Social Work Research , Volume 35, Issue 1, March 2011, Pages 11–19, https://doi.org/10.1093/swr/35.1.11

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This study was conducted to describe strategies used by social work researchers to enhance the rigor of their qualitative work. A template was developed and used to review a random sample of 100 articles drawn from social work journals listed in the 2005 Journal Citation Reports: Science and Social Sciences Edition . Results suggest that the most commonly applied strategies were use of a sampling rationale (67%), analyst triangulation (59%), and mention of methodological limitations (56%); the least common were negative or deviant case analysis (8%), external audit (7%), and specification of ontology (6%). Of eight key criteria, researchers used an average of 2.0 ( SD = 1.5); however, the number used increased significantly between 2003 and 2008. The authors suggest that for this trend to continue, social work educators, journal editors, and researchers must reinforce the judicious application of strategies for enhancing the rigor of qualitative work.

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Triggers and factors associated with moral distress and moral injury in health and social care workers: A systematic review of qualitative studies

Affiliations.

• 1 Department of Psychology, Sport and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.
• 2 Intensive Care Unit, Royal Free Hospital, London, United Kingdom.
• 3 Centre for Research in Public Health and Community Care, School of Health and Social Work, The University of Hertfordshire, Hatfield, United Kingdom.
• PMID: 38935754
• PMCID: PMC11210881
• DOI: 10.1371/journal.pone.0303013

Objective: At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action, as it aligns with their own values; a phenomenon known as moral distress. Similarly, there are increasing reports of healthcare workers experiencing long-term mental and psychological pain, alongside internal dissonance, known as moral injury. This review examined the triggers and factors associated with moral distress and injury in Health and Social Care Workers (HSCW) employed across a range of clinical settings with the aim of understanding how to mitigate the effects of moral distress and identify potential preventative interventions.

Methods: A systematic review was conducted and reported according to recommendations from Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were conducted and updated regularly until January 2024 on 2 main databases (CENTRAL, PubMed) and three specialist databases (Scopus, CINAHL, PsycArticles), alongside hand searches of study registration databases and other systematic reviews reference lists. Eligible studies included a HSCW sample, explored moral distress/injury as a main aim, and were written in English or Italian. Verbatim quotes were extracted, and article quality was assessed via the CASP toolkit. Thematic analysis was conducted to identify patterns and arrange codes into themes. Specific factors like culture and diversity were explored, and the effects of exceptional circumstances like the pandemic.

Results: Fifty-one reports of 49 studies were included in the review. Causes and triggers were categorised under three domains: individual, social, and organisational. At the individual level, patients' care options, professionals' beliefs, locus of control, task planning, and the ability to make decisions based on experience, were indicated as elements that can cause or trigger moral distress. In addition, and relevant to the CoVID-19 pandemic, was use/access to personal protection resources. The social or relational factors were linked to the responsibility for advocating for and communication with patients and families, and professionals own support network. At organisational levels, hierarchy, regulations, support, workload, culture, and resources (staff and equipment) were identified as elements that can affect professionals' moral comfort. Patients' care, morals/beliefs/standards, advocacy role and culture of context were the most referenced elements. Data on cultural differences and diversity were not sufficient to make assumptions. Lack of resources and rapid policy changes have emerged as key triggers related to the pandemic. This suggests that those responsible for policy decisions should be mindful of the potential impact on staff of sudden and top-down change.

Conclusion: This review indicates that causes and triggers of moral injury are multifactorial and largely influenced by the context and constraints within which professionals work. Moral distress is linked to the duty and responsibility of care, and professionals' disposition to prioritise the wellbeing of patients. If the organisational values and regulations are in contrast with individuals' beliefs, repercussions on professionals' wellbeing and retention are to be expected. Organisational strategies to mitigate against moral distress, or the longer-term sequalae of moral injury, should address the individual, social, and organisational elements identified in this review.

Copyright: © 2024 Beadle et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Health care workers’ self-perceived meaning of residential care work

• Sui Yu Yau 1 ,
• Yin King Linda Lee 1 ,
• Siu Yin Becky Li 1 ,
• Sin Ping Susan Law 1 ,
• Sze Ki Veronica Lai 1 &
• Shixin Huang 2  

BMC Health Services Research volume  24 , Article number:  766 ( 2024 ) Cite this article

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Attracting and supporting a sustainable long-term care (LTC) workforce has been a persistent social policy challenge across the globe. To better attract and retain a sustainable LTC workforce, it is necessary to adopt a unified concept of worker well-being. Meaning of work is an important psychological resource that buffers the negative impacts of adverse working conditions on workers’ motivation, satisfaction, and turnover intention. The aim of this study was to explore the positive meaning of care work with older people and its implications for health care workers’ job satisfaction and motivation to work in the LTC sector.

This study adopted a qualitative descriptive design that pays particular attention to health care workers; such as nurses, personal care workers; as active agents of the meaning making and reframing of care work in LTC communities in a East Asia city. In-depth semi-structured interviews were conducted with thirty health care workers in LTC communities in Hong Kong. Thematic analysis was employed for data analysis.

The research findings indicate that while health care workers perform demanding care work and experience external constraints, they actively construct positive meanings of care work with older people as a helping career that enables them to facilitate the comfortable aging of older people, build affectional relationships, achieve professional identity, and gain job security.

Conclusions

This qualitative study explores how health care workers negotiate the positive meaning of older people care work and the implications of meaningful work for workers’ job satisfaction and motivation to work in the LTC sector. The importance of a culturally sensitive perspective in researching and developing social policy intervention are suggested.

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Introduction

Recruiting and retaining health care workers (HCWs) in the long-term care (LTC) sector is a persistent worldwide social policy challenge [ 1 ]. Across the globe, population aging will create significantly higher demands for LTC services for older people. These demands include residential care services, especially among older people with complex care needs due to age-related disabilities and chronic diseases [ 2 ]. Comprised mainly of nurses and personal care workers, HCWs in LTC communities perform a variety of tasks that are essential to maintain the functional ability of older people, including helping with activities of daily living (ADL) (such as bathing, toileting and eating), instrumental activities of daily living (IADL) (such as taking medication), monitoring and coordinating care, and communicating with older people and their families [ 3 ]. Despite the growing demand and significance of LTC services, health care work in LTC communities is often devalued as “dirty work” and characterized by low wages, precarious working conditions, limited career development opportunities, understaffing, and work overload [ 4 ].

In the context of LTC communities, while the research to date has extensively evaluated the demanding working conditions that lead to negative well-being outcomes for HCWs [ 1 ], relatively little is known about the positive meaning that HCWs experience in, and attribute to, their care work in LTC communities [ 5 ]. Further exploration of how HCWs engage in meaningful work is helpful to the development of strategies that improve worker well-being and other work outcomes in LTC communities, especially job satisfaction and worker retention. In addition, cultural and social contexts exert a heavy influence on the meaning of care [ 6 ]. Most of the current literature on older people care work has been produced and addressed in Anglo-American contexts; there are limited evaluations of the meanings and experiences of older people care work from the perspectives of HCWs in East Asia, a region that is characterized by a large, rapidly aging population and unique socio-cultural meanings of older people care. A culturally sensitive understanding of what contributes to meaningful work in the LTC setting is thus needed to attract and support the LTC workforce beyond the Western contexts. Thus, this qualitative study aims to examine how HCWs in LTC communities construct positive meanings of older people care and also the implications of meaningful work for their job satisfaction and intention to stay in the LTC sector in Hong Kong, in the People’s Republic of China. This study is produced as part of a larger research project examining the social construction of stigma attached to older people care work in Hong Kong’s LTC communities [ 7 ] and pays particular attention to HCWs’ meaning construction in relation to the policy, organizational, and socio-cultural contexts to inform LTC workforce development policy.

Constructing meaning of work in LTC communities

Meaning of work (MOW) is an important psychological resource that buffers the negative impacts of adverse working conditions on workers’ motivation, satisfaction, and turnover intention [ 8 , 9 ]. Across different occupational contexts, organizational scholars have consistently found that MOW is a significant aspect of workers’ subjective well-being and is associated with positive worker and organizational outcomes, including higher work engagement, organizational commitment, worker retention, and productivity [ 10 ]. MOW refers to “employees’ understandings of what they do at work as well as the significance of what they do” [ 11 ]. It captures how employees make sense of their experiences at work, as well as the role of work in the context of life [ 12 ]. MOW consists of three primary facets: positive meaning in work, meaning making through work, and greater good motivation [ 13 ]. Meaning in work concerns individuals’ subjective interpretations of experiences and interactions at work in terms of the values, attitudes, and beliefs that they see as intrinsic to the nature of their work and working relationships [ 10 ]. Meaning making through work involves the idea that work could serve as a critical avenue for meaning making in life, such as facilitating personal growth, deepening self-understanding, and attaining personal and professional identity [ 14 ]. Lastly, greater good motivation implies the perception that one’s work has positive impacts on the greater good, ranging from generating positive contributions to others to responding to the meaning of work [ 15 ].

Although MOW is experienced by individual employees as feelings and cognitions, a sociological perspective of MOW suggests that the meaning individuals ascribe to their work is constructed within an array of socially influenced worldviews regarding the value of their work activities [ 16 ]. Individuals’ meaning making of their jobs, roles, and selves at work is a dynamic process that is influenced by the social and interpersonal valuation and devaluation of their work [ 11 ]. Work in the LTC sector is often socially constructed as “dirty work” that is physically, socially, and morally tainted [ 17 , 18 ]. The social discourses on “dirty work” are further reinforced by the emotionally and physically demanding nature of care work, as well as the poor job quality in the LTC sector [ 19 ]. Work in LTC communities is typically characterized by poor compensation, heavy workloads, precarious part-time employment, limited career development prospects, limited training and supervision, and low occupational status compared to other healthcare fields [ 20 ].

Given these external constraints, it is not surprising that HCWs in LTC communities feel disempowered to make positive sense of their care work [ 21 ], which in turn negatively influences their job satisfaction and intention to work in the LTC sector [ 17 ]. Despite the social devaluation and demanding nature of older people care work, HCWs in LTC communities could actively engage in negotiating the meaning of their work and construct positive career identities to overcome the taint of dirty work, a research theme that to date remains underdeveloped [ 22 ]. These positive meanings might include forming caring relationships with older people [ 5 ].

Residential care services and LTC workforce in Hong Kong

Health care workers in LTC communities negotiate the meaning of care work within particular social policy, organizational, and socio-cultural contexts [ 7 ]. Given the drastically increasing demand for residential care among older people, the chronic workforce crisis in the LTC sector, and the transforming socio-cultural meaning of care for older people [ 4 ], it has never been timelier to explore the meaning of work in Hong Kong’s LTC communities.

Hong Kong is an economically advanced metropolis located in the Southern part of China. With increasing life expectancy, Hong Kong’s aging population is projected to increase from 1.12 million (or 15% of total population) in 2015 to 1.51 million (or 30.6% of total population) in 2043, significantly higher than the OECD (Organisation for Economic Co-operation and Development) average percentage (25% in 2043) [ 23 ]. As a result, the demand for LTC services, including residential care services, will also increase drastically. The limited residential spaces, the transformation of family structure, and the imbalanced public investment in community and residential care have turned the number of older people who require residential care in Hong Kong into one of the highest among developed economies [ 24 ].

Hong Kong adopts a hybrid model in the financing and provision of its residential care services. In 2022, there were about 76,200 older people require residential care in Hong Kong, among which 46% (or a total number of 35,040) were subsidized by the government and 54% (or a total number of 41,160) were non-subsidized [ 25 ]. While residential care services in general are provided by non-governmental organizations (NGOs) (31%) and the private sector (69%), the majority of subsidized residential services are provided by NGOs, although the government also purchases subsidized places and services from private facilities [ 26 ]. Like many developed economies, Hong Kong has experienced an acute shortage of HCWs in LTC communities [ 26 ]. Even though the Hong Kong government has initiated many measures over the past few years to tackle the issues of the care workforce crisis, such as increasing salaries, launching different schemes to train young people and encouraging migrant workers to join the LTC communities, 20% of HCW positions in LTC communities remain vacant [ 27 ].

HCWs’ well-being is indeed connected to workforce attraction and retention. Despite the Hong Kong government initiating various ongoing measures to increase the number of workforce in LTC sector, there will be a shortfall of 4,500 HCWs in the next three year [ 28 ]. To better attract and retain a sustainable LTC workforce, it is necessary to adopt a unified concept of worker well-being that not only addresses the structural factors, such as economic and physical working conditions, but also the subjective factors that attract and motivate workers to join and remain in the LTC sector, including promoting meaningful, valued work [ 29 , 30 ]. Caring for older people entails unique socio-cultural meanings in Hong Kong and East Asian societies. Although sociodemographic changes have transformed the patterns of social care for older people, most noticeably exemplified by the rising demand for residential care, such cultural norms still exert significant influences on the meaning of care work [ 31 ]. The aim of this study was to explore the positive meaning of care work with older people and its implications for health care workers’ job satisfaction and motivation to work in the LTC sector.

This study adopted a qualitative descriptive design that focuses on HCWs as active agents of the meaning making and reframing of care work in LTC communities. The use of qualitative descriptive design is common in health care research because of its simplicity and flexibility in diverse healthcare environment. Qualitative research is appropriate to explore experiences and perceptions on subjective nature of a phenomenon. It is especially suitable for nursing and healthcare studies that interested in individual’s experience [ 32 ]. Thus, this design is particularly relevant to this study which aimed to explore the positive meaning of care work with older people and its implications for health care workers’ job satisfaction and motivation to work in the LTC sector.

In the context of Hong Kong, HCWs in LTC communities include personal care workers (PCWs) who take care of residents’ ADL and IADL, health workers (HWs, largely equivalent to “certified nursing assistants” in the United States) who monitor the work of PCWs and are responsible for the delivery of basic nursing care, and enrolled nurses (ENs) and registered nurses (RNs) who provide nursing care and oversee the work of PCWs and HWs.

Recruitment sample

Purposive sampling was used to recruit HCWs from LTC communities as research participants. To meet the inclusion criteria, participants had to (1) be serving in the role of a PCW, HW, EN, or RN; (2) have at least 6 months of experience working in an LTC community; and (3) be providing frontline services to older people. The exclusion criteria were as follows: (1) LTC workers who had only a managerial role and did not provide frontline care; (2) LTC workers working in other roles (e.g., social workers, occupational therapists, physical therapists). In the process of participant recruitment, the maximum variation sampling method was used to ensure the heterogeneity of participants in terms of participants’ characteristics. The use of maximum variation sampling method aimed to recruit information-rich participants and to capture the widest range of possible perspectives [ 33 ]. Thus, in order to ensure maximum variation, this study recruited participants based on a variety of nature such as gender, age, role and rank, years of work experience, and types of LTC communities worked for including publicly subsidized and private communities.

Six LTC communities were approached by the researchers. The managerial staff of each LTC community was invited to refer potential participants to the researchers after briefed for the purpose of the study, as well as the inclusion and exclusion criteria of the sample. The researcher (S. Huang) liaised with the managerial staff to schedule the logistics. Participants were fully informed of the purpose and procedures of the study. Informed consents were obtained before data collection commenced. Pseudonyms were used in the study in order to protect participants’ identities.

Data were collected between February 2021 and December 2021. Thirty participants were recruited in the study. The average age of the participants was 37 years old, and their mean years of tenure in the care sector were 7 years. Reflecting the gender ratio of the overall population of the care workforce, 5 participants were male and 25 were female. Thirteen of the participants worked as nurses (five RNs and eight ENs), eight worked as HWs, and nine were PCWs. Sixteen participants had attained a post-secondary education and 13 had earned secondary education, with only one participant having received primary or below education (see Table 1 for demographic data of the participants) [see Additional file 1].

Data collection

Semi-structured in-depth interviews were conducted. Interviewers were trained in qualitative study methods and came from a variety of healthcare research backgrounds of nursing and social work. Interviews were conducted in private meeting rooms in LTC communities. Interview sessions lasted from 30 to 80 min (mean = 55 min). Cantonese was adopted in the interviews. An interview guide was developed for this study [see Additional file 2]. Each interview began with general questions revolving around the nature of the participant’s work and daily work routines, followed by exploratory questions that unraveled the meanings the participant made from her/his work. With the written informed consent of participants, all interviews were audio-recorded and transcribed verbatim.

Data analysis

Thematic analysis [ 34 ] was used to analyze the interview data. Adopting an inductive approach to analysis, this study followed the six-phase approach to thematic analysis that includes (1) data familiarization, (2) coding, (3) initial theme generation, (4) theme development and review, (5) refining, defining and naming themes, and (6) writing up [ 35 ]. Two experienced qualitative researchers (V. Lai and S. Huang) coded each interview transcript independently. Transcripts were coded with the facilitation of the qualitative research data analysis software NVivo 12. All the authors met regularly to review interview transcripts, compare coding, and generate initial analytical themes together. Disagreements regarding coding were raised and discussed in team meetings until agreements were reached. Two authors then finalized the processes by developing, reviewing, refining, defining, and naming themes.

The trustworthiness and rigor of the study was ensured by credibility, dependability, confirmability and transferability [ 36 ]. In order to enhance the credibility, two researchers read the transcripts and conduct coding independently for comparison. They discussed the emergent themes and codes until a consensus was researched. Dependability was achieved by using an audit trail that detailed the description of the research process to reduce bias. Peer debriefing with an expertise was used for confirmability. Transferability of findings was attained by describing the participant characteristics and the methodology of the study transparently and comprehensively in order to allow readers understood the strengths and limitations of the study.

Engaging in care for others can be highly rewarding work as reflected from the participants. Five themes identified from the data that articulated the positive meaning that HCWs ascribed to their work in LTC communities, including (1) “My work makes their lives more comfortable”: Helping older people to age comfortably; (2) “Everyday our affections increase”: Building meaningful relationships; (3) “These are all skills”: Forming a professional identity of older people care; (4) “I want to find a job that ensures I will never be unemployed”: Ensuring job security; and (5) “They are extra work”: Barriers to attaining the positive meaning of work.

“My work makes their lives more comfortable”: Helping older people to age comfortably

When making meaning of their work, the HCWs most frequently evoked the notion of helping older people to “age comfortably” in LTC communities. The idea of comfortable aging, as suggested by HCWs in this study, referred to both physical well-being (i.e., having desirable health outcomes and being free of pain) and psychosocial well-being. The physical and psychosocial well-being entailed the traditional socio-cultural values in Chinese society.

The HCWs suggested that their care activities supported older people’s comfortable aging by maintaining and even improving their physical health. The HCWs in LTC communities engaged in a variety of caregiving tasks in their everyday work. The daily work routine of the HWs, ENs, and RNs revolved around addressing the health needs of older residents through clinical and medical activities such as wound dressing, medication administration, peritoneal dialysis, tube feeding, etc. The care activities of the PCWs included personal care such as assisting with bathing, dressing, eating, toileting, transferring, grooming, etc., depending on the frailty level of the older residents. The HCWs suggested that they found their work meaningful because their care activities were helpful to older residents achieving desirable health outcomes.

I feel happy because my work makes their lives more comfortable. For example, a resident’s wound was quite severe and was at stage one or stage two before intervention. Then, we had multiple interventions and dressed the wound one shift after another until it finally healed. I gained a sense of fulfillment in the process. This process made me feel that our care was effective. (EN2)

As demonstrated by a participant, in the process of helping older people maintain their physical health, HCWs gain a strong sense of self efficacy and job satisfaction. Even though the HCWs pointed out that their care did not always lead to full recovery as many older people in LTC communities are physically frail and experiencing health deterioration, they deemed their work to be meaningful because it helped older people maintain the highest level of physical comfort possible.

Not everyone recovers. Some are not in a good condition, but at least my care helps to ensure they are not too bad. Even though they cannot recover fully, their wounds might get smaller or not deteriorate any more. They don’t feel so much pain… They can feel more comfortable. (HW3)

In addition, the HCWs suggested that their everyday care conveys companionship and psychological support to older people in LTC communities, which is also essential to their comfortable aging.

Actually, the meaning of taking care of them is about being part of their last journey of life. In other words, I can create a happy and comfortable later life for them before they pass away. There is someone who can talk with them and provide good care to them. For me, that is what nursing care is about. (EN4)

The idea of facilitating comfortable aging espoused by HCWs has socio-cultural relevance in Chinese society, where providing care to older people to enable their comfortable aging is seen as a moral virtue. Several HCWs, including those in younger ages, framed their care as rewarding and meaningful work as they believed that taking good care of older people would “accumulate good karma” for themselves and their family.

I quite like taking care of older people. It is like some sort of traditional thought… I think taking care of older people is accumulating good karma. I believe that this is beneficial to my family and myself. (EN1) I think it is accumulating good karma. When taking care of older people, I am thinking that if I take good care of them now, I will be treated well by others when I get old and need care from others in the future. I do my work with this mindset. Therefore, I do not see my work as hard or dirty. (HW4)

“Every day our affections increase”: Building meaningful relationships

The second theme that the HCWs ascribed to their work concerned the valuable long-term relationships they built with older residents in their daily work, through which they found joy and personal growth.

HCWs, especially the nurses, constantly drew comparisons between LTC communities and other health care settings, such as hospitals, when discussing the meaning of their work. They suggested that working in a LTC facility allowed them to form long-term, genuine bonds with the older people they cared for, something they argued was rarely possible elsewhere. According to a participant, residential homes allow “the cultivation of human relationships and affection that is absent in hospitals” (RN3). A participant further elaborated:

I like talking with people. Working in a hospital is like fighting a war. I had no time to know the backgrounds of my patients. I couldn’t even remember their names when they were discharged from the hospital. Then, I will never see them again… However, LTC communities are very different. The conditions of the older people we serve are more stable. I have more time to get along with them. (EN6)

The cultivation of relationship involves human interaction and emotional exchange as reflected from the participants. The HCWs believed that they were the ones who provided “close, personal care” to the residents. In the process of performing everyday care activities, they had frequent interactions and developed close relationships with older people. Many participants suggested that being able to communicate and interact with older people was the most enjoyable part of their work. Despite the challenges of caregiving work, participants found their relationships with older residents “joyful”, “satisfying”, and “rewarding”.

When I perform my work and provide care to them, I gain joy and fun out of it. I feel happy to interact with people. [The happiness] is very personal. It might be chatting with a resident and receiving an unexpected response. Some residents with dementia are very funny. They always come up with something unexpected and make me feel happy. (HW4) The sense of satisfaction comes from my interactions with older people. Every day, our affections increase. They treat me like their granddaughter. I think acknowledgement from the boss does not matter a lot; I feel the biggest sense of satisfaction by getting the acknowledgement of the older people. They personally experience how well I deliver care. (EN5)

Moreover, some HCWs reported that their relationships with older residents were “reciprocal”, not only because they constantly received appreciation from the residents but also, more importantly, because they were able to learn “old wisdom” and achieve personal growth from the lived experiences of the older residents.

It is not only about providing a service to them; sometimes when I talk with them, they offer me their perspectives, from which I can learn something. This is more like a reciprocal relationship…Sometimes, the older people have old wisdom and special perspectives. (RN4) I think I learn a lot from the older people because I meet a lot of people here and learn about their lived experiences from our conversations. They like sharing with me and I can reflect upon myself… (HW5)

“These are all skills”: Forming a professional identity of older people care

HCWs proposed that older people care is highly skillful and professional, requiring communication, coordination, and chronic illness care skills. Being able to form a professional identity as a HCW for the older people thus constituted a salient MOW for the participants.

Participants in this study reported that they constantly experienced devaluation of their work by their family, friends, and health care professional allies, who regarded care work in LTC communities as “dirty, less skilled, and unprofessional”.

People imagine that this work is about changing diapers and dealing with shit and piss… My aunt used to say to me that she’d rather beg than work in a residential home. People are not willing to join this sector because they think older people care is dirty work and cannot accept dealing with human excreta. (PCW4) They think that we work here because our nursing skills are not competent enough to work as hospital nurses. But when they hear that I am working in an LTC community, they doubt that my work is different from that in hospitals. They doubt that we work here because our nursing skills are not competent enough to work as hospital nurses. (EN6)

Contrary to the negative evaluations of their work, the HCWs evoked positive meanings of care work in LTC communities. One participant described that care in LTC communities and care in hospitals were “both part of the continuum of care that tackles the different health needs of older people, ranging from acute disease to long-term chronic illness” (RN5). More importantly, their care work in LTC communities allowed them to reimagine the nature of health care from delivering physical care tasks to providing holistic care that included psychological support, health education, human communication, resource coordination, and organizational management.

It is wrong to assume that nurses working with older people are not professional. Instead, we are differently professional in our specialties. For hospital nurses, their professional expertise lies in emergency treatment. But working in LTC is professional in terms of mastering the daily operation of a facility, governmental ordinances, and communication with family members. (RN2)

While the HCWs framed their work as valuable and professional, the HCWs described how performing personal care for older residents, such as positioning, lifting, transferring, feeding, and bathing, requires specialized knowledge, training, and experience.

Everything, every machine here requires specialized knowledge and training to handle. It is not that straightforward and simple. So, working as a PCW is not only about changing diapers. We need to grasp health and medical knowledge to monitor older peoples’ vital signs. We must also monitor whether the older people have bruises or wounds. We must be very careful to know whether the older people are doing ok. These are all skills. (PCW2)

Participants indicated that there were many other aspects that distinguished them as “professional” that further produced meanings and values in their personal life. One participant, a HW, indicated that working in LTC communities enabled her to work with interdisciplinary professionals such as doctors, nurses, nutritionists, social workers, physical therapists, and occupational therapists and thus allowed her to gain health knowledge. Many HCWs mentioned that the older people care knowledge and skills they learned from work could be useful in their personal life, particularly in terms of taking care of their older parents and grandparents at home.

“I want to find a job that ensures I will never be unemployed”: Ensuring job security

HCWs, especially PCW and HW working in government-subsidized facilities, perceived that the LTC sector offers relatively promising job opportunities and security, a stable income, and a career development pathway. These instrumental values made the LTC sector attractive for the participants.

Across the globe, the LTC sector has long been suffering from the challenge of workforce shortage. For participants in this study, however, this challenge was perceived as a positive opportunity that added value to their jobs. Many proposed that they found older people care as meaningful work because with the trend of population aging, there would always be increasing workforce demands in the job market which could provide them with promising job opportunities and security. Some HCWs also mentioned that the job offered them income stability, which they deemed as valuable compared to other work in the service industry.

The availability of job stability and opportunities in older people care work was particularly salient for participants during the COVID-19 pandemic, when the unemployment rate was high due to economic recession. Several participants described that they joined the LTC sector during the COVID-19 pandemic for the stability it offered. For example, a participant described, “I was working in the hotel industry…Then I lost my job and couldn’t find a new one. I wanted to find a job that will ensure I will never be unemployed.” (PCW5).

In addition, participants suggested that they found their work meaningful because of the relatively promising career development opportunities. The LTC sector in Hong Kong provides HCWs with a career pathway and ladder to pursue career development. Although promotion and degree admission opportunities are highly competitive, some participants saw the career ladder that moves up from PCW, HW, and EN to RN as a promising pathway for them to gain better income and work benefits.

“They are extra work”: Barriers to attaining meaning of work

Despite the HCWs ascribing a variety of positive meanings to their work, they admitted that it was not always possible to attain these meanings in their everyday work. They identified several barriers to attaining MOW, including the lack of organizational support for relational care, heavy workloads and workforce shortages, as well as emotional burnout.

As described above, HCWs found that the relational components of their work, particularly the helping relationships and affectional interactions with older residents, made the work highly meaningful. However, participants reported that although the LTC sector had long placed emphasis on person-centered care, they received little organizational support to develop meaningful relationships in their everyday work. Given that their daily work routines and timetables were predominantly organized around the delivery of physical caregiving tasks, many HCWs described an important and meaningful part of care work – relationship building and psychological support – as “extra” work that received little organizational recognition.

Of course, a lot of my work with the residents is extra work. I prefer to deliver holistic care that goes beyond physical care. Physical care tasks are those that appear on the timetable. But for the other parts, I must address them for the residents at other times by myself. (RN1)

Moreover, the heavy workloads and the chronic lack of workers in LTC communities impose further strains on HCWs in fulfilling their daily work routines, making it even more difficult for them to provide relational care. Despite these organizational constraints, the HCWs reported that they creatively made time and space in and between their work routines to build relationships and address older residents’ psychosocial well-being needs.

When I distribute medications, I usually have casual chats with the residents by greeting them and asking how their sleep and meals went. Just chatting. But it depends on the situation. When accidents happen, I would be too busy to handle this. (HW2) Sometimes I am very busy and do not have time to interact with the residents at all… I usually use meal times when I am more or less available. Residents are usually sitting and waiting for meals before we distribute them. I will use the ten minutes or so to chat with them. (HW1)

Relationship building and affectional interaction can be satisfying and exhausting simultaneously. The HCWs described the high emotional demands from older people and their family members they had to bear in their everyday work, which frequently put them in a situation of emotional burnout which can detract from building meaning. In addition, some HCWs reported that it took a lot of emotional labor (i.e. to manage feeling as to fulfill job requirement) to care for older residents with difficult behaviors or personalities, especially those with declining mental health and dementia. They said that they constantly experienced distrust, blaming, and rejection from older residents when they performed caregiving tasks such as feeding, which added a considerable amount of strain to their work. Similarly, the HCWs had to deal with constant distrust and misunderstanding from residents’ family members, which caused some of them frustration and stress.

This is work that cannot get understanding from everyone. Some [family members of the residents] would not notice my efforts to care for the residents. However, if I make a minor mistake, they will blame me. Human beings make mistakes and are not perfect. I am also sincerely concerned for the older people, but they don’t understand and blame me for my mistake. (PCW7)

This study examines HCWs’ engagement in meaningful work in LTC communities in the context of an economically developed Chinese society in Hong Kong. It is found that HCWs deemed their work to be a meaningful helping career that facilitated comfortable aging for older people and connoted positive socio-cultural values. They further attributed their MOW to the valuable relationships developed in their daily work and to the positive professional identity and relatively promising job security in their work, although the attainment of positive MOW was hindered by a number of barriers. In this discussion, we describe how these findings can support social policy initiatives to attract, retain, and support the LTC workforce.

To date, research and social policy interventions on LTC workforce development have largely focused on structural factors that influence the retention of HCWs and their job satisfaction [ 37 ]. Studies informed by this line of inquiry have identified the importance of working conditions, especially pay and compensation, workload and staffing level, teamwork, and supervision, in shaping work-related outcomes [ 29 , 38 , 39 ]. Even though the positive organizational scholarship has long argued the beneficial impacts of positive psychological states, including perceptions of meaningful work, on workforce functioning and productivity [ 40 ], relatively little attention has been paid to positive working experiences in the LTC sector. Our study moves a step forward from the current literature by shedding light on the subjective meaning making of work as an important, yet often overlooked, aspect of direct care work in LTC communities. While the structural factors of working conditions are pivotal to the job quality in LTC communities, MOW can serve as a psychological resource that engenders positive emotions and motivates HCWs to engage in direct care work in LTC communities. The findings of this study thus provide nuanced evidence about promoting meaningful work as a promising intervention for LTC workforce development. This could be done by addressing structural factors such as promoting job security, improving time and resource constrains, enhancing organizational support in LTC communities. Also, this could be done by supporting relationship building and better integrating psychosocial care into older people care work and exploring socio-cultural resources that contribute to positive meaning making of older people care work. In addition, as an extension of this qualitative study, quantitative research that examines the impacts of MOW on workers’ turnover intention and job satisfaction, as well as MOW as a mediating mechanism in explaining the impacts of working conditions on worker outcomes in the LTC sector, will be an important area for future exploration.

The findings of this study also imply that the meaning construction of older people care should be further understood and supported in the broader contexts, including the LTC policy, organizational support, and the socio-cultural meaning of older people care. As indicated by our research findings, the professional identity and job security in the LTC sector are important parts of HCWs’ MOW. While research to date has stressed the lack of job security and professional status in the LTC sector [ 41 ], our study has provided somewhat contradictory findings. Participants in the present study has relatively positive perceptions about career prospects in the LTC sector, proposing that the growing demand for LTC in the face of population aging entails job opportunities and job security, both of which make a career in LTC attractive. The nurses highlighted that their work was different to but equally as professional, skilled, and challenging as acute hospital care. Some indicated that their nursing care experiences in LTC communities allowed them to develop specialties in chronic disease management to maintain the wellness and quality of life of older people. This positive perception of LTC work is partly shaped by the preliminary, yet far from finished, social policy attempts to professionalize the LTC workforce in the local context. In Hong Kong, LTC policy has laid out the foundation of a relatively promising career development pathway in the nursing profession for HCWs in the LTC sector, most noticeably through the establishment of the Vocational Qualifications Pathway (VQP) for the LTC service industry and professional training programs [ 42 ]. Our findings thus call for research and social policy interventions to address the professionalization of the LTC sector and enable HCWs to gain public recognition, rewarding pay, job security, and career development.

Additionally, the findings of this study add to the existing studies on working conditions in LTC communities by highlighting the lack of organizational support for relational care as an organizational barrier to attaining meaningful work. Our study echoes existing research findings that HCWs deem affectional interactions and long-term relationships with older people as meaningful and valuable [ 29 ]. Yet HCWs’ yearning for meaningful relationships with older people is constantly constrained by the organizational structures of LTC communities, particularly the traditional institutional model of care centered around measurable and functional caregiving tasks [ 43 , 44 ]. The culture change movement that calls for humanizing care practice by transforming the institutional form of care in LTC communities to person-centered and relational care [ 45 , 46 ]. This culture change movement is thus particularly relevant to promoting the meaningful work of HCWs. Facilitating positive, meaningful working experiences for the LTC workforce would require changes in the organizational cultures of LTC communities to enable flexible caregiving routines, professional training opportunities that address relationship and rapport building, and a humanizing working environment.

Lastly, the meaning of older people care is constructed under an array of socio-cultural values. Even though increasing scholarly attention is being paid to revealing a culturally sensitive approach to older people care [ 47 ], very few studies have examined the socio-cultural meanings and values attached to older people care work from HCWs’ perspectives in the international contexts. As illustrated in this study, the notion of facilitating comfortable aging was seen as “accumulating good karma” and contained socio-cultural meaning towards older people care within the Chinese society. While engaging in older people care work is socially constructed as a “dirty work” [ 17 ], it could entail cultural salience and be regarded as a rewarding career in a society that values the life experience and moral authority of older people. This finding thus reveals the importance of a culturally sensitive perspective in researching and developing social policy interventions for LTC workforce development, including promoting a culturally resonant positive image of work in the LTC sector. This policy implication is not only resonant to other Asian societies, but also to the international contexts as Asian migrant workers represent a considerable proportion of the LTC workforce in developed countries such as Australia, US, UK and other European countries [ 48 , 49 ].

Limitations

Although this study adopted the maximum variation sampling method to increase the variety of HCWs’ perspectives and experiences, its use of purposive sampling is limited in representativeness. Additionally, this research intended to explore the MOW for all types of HCWs (eg, EN, RN, HW, PCW). However, these HCWs have quite different working experiences and work meaning because of different job quality and professional status. As non-nurses are particularly vulnerable to the deprivation of subjective well-being in work because of the poor job quality of their work [ 5 ], future studies would benefit from examining the subjective meaning making of work among this specific group of workers.

This qualitative study explores how HCWs negotiate the positive meaning of older people care work and the implications of meaningful work for workers’ job satisfaction and motivation to work in the LTC sector in Hong Kong’s LTC communities. While HCWs perform physically and emotionally demanding care work, they actively construct a subjective meaning of older people care as a helping career that enables them to facilitate comfortable aging of older people, build affectionate relationships, achieve professional identity, and gain job security. Their construction of meaningful work is further discussed in an array of social policy, organizational, and socio-cultural factors that all entail future research and social policy implications of LTC workforce development.

Availability of data and materials

The datasets generated and analysed during this study are not publicly available to protect the participant' confidentiality. However, they are available from the corresponding author upon reasonable request.

Abbreviations

Activities of daily living

Enrolled nurses

Health care workers

Health workers

Instrumental activities of daily living

Long-term care

Meaning of works

Personal care workers

Registered nurses

Llena-Nozal A, Rocard E, Sillitti. Providing long-term care: options for a better workforce. Int Soc Sec Rev. 2022;75:121–44. https://doi.org/10.1111/issr.12310 .

Article   Google Scholar  

United Nations. Growing need for long-term care: assumptions and realities. 2016. https://www.un.org/esa/socdev/ageing/documents/un-ageing_briefing-paper_Long-term-care.pdf .

OECD. Who cares? attracting and retaining elderly care workers. 2020. https://doi.org/10.1787/92c0ef68-en .

Scales K. It is time to resolve the direct care workforce crisis in long-term care. Gerontologist. 2021;61:497–504. https://doi.org/10.1093/geront/gnaa116.PMID:32853357;PMCID:PMC7499598 .

Article   PubMed   Google Scholar  

Vassbø TK, Kirkevold M, Edvardsson D, et al. The meaning of working in a person-centred way in nursing homes: a phenomenological-hermeneutical study. BMC Nurs. 2019;18:45. https://doi.org/10.1186/s12912-019-0372-9.PMID:31632193;PMCID:PMC6790040 .

Article   PubMed   PubMed Central   Google Scholar  

Leininger M. Special Research Report: Dominant culture care (EMIC) meanings and practice findings from Leininger’s Theory. J Transcult Nurs. 1998;8(2):45–48. https://doi.org/10.1177/104365969800900207 .

Lai VS, Yau SY, Lee LY, et al. Caring for older people during and beyond the COVID-19 pandemic: experiences of residential health care workers. Int J Environ Res Public Health. 2022;19(22):15287. https://doi.org/10.3390/ijerph192215287.PMID:36430006;PMCID:PMC9692584 .

Arnoux-Nicolas C, Sovet L, Lhotellier L, et al. Perceived work conditions and turnover intentions: the mediating role of meaning of work. Front Psychol. 2016;7:704. https://doi.org/10.3389/fpsyg.2016.00704.PMID:27242616;PMCID:PMC4863887 .

Humphrey SE, Nahrgang JD, Morgeson FP. Integrating motivational, social, and contextual work design features: a meta-analytic summary and theoretical extension of the work design literature. J Appl Psychol. 2007;92:1332–56. https://doi.org/10.1037/0021-9010.92.5.1332 . PMID: 17845089.

Steger MF, Dik BJ. Work as meaning: individual and organizational benefits of engaging in meaningful Work. Oxf Handbook Pos Psy Work. 2009. https://doi.org/10.1093/oxfordhb/9780195335446.013.0011 .

Wrzesniewski A, Dutton JE, Debebe G. Interpersonal sensemaking and the meaning of work. Res Org Behavior. 2003;25(03):93–135. https://doi.org/10.1016/S0191-3085(03)25003-6 .

Rosso BD, Dekas KH, Wrzesniewski A. On the meaning of work: a theoretical integration and review. Res Organ Behav. 2010;30:91–127. https://doi.org/10.1016/j.riob.2010.09.001 .

Steger MF, Dik BJ, Duffy RD. Measuring meaningful work: the Work and Meaning Inventory (WAMI). J Car Ass. 2012;20:322–37. https://doi.org/10.1177/1069072711436160 .

Westwood R, Lok P. The meaning of work in chinese contexts. Int J of Cross Cultural Mgt. 2003;3(2):139–65. https://doi.org/10.1177/14705958030032001 .

Dik BJ, Duffy RD. Calling and vocation at work. Couns Psychol. 2009;37:424–50. https://doi.org/10.1177/0011000008316430 .

Dutton JE, Debebe G, Wrzesniewski A. Being valued and devalued at work: a social valuing perspective. In B. A. Bechky & K. D. Elsbach (Eds.), Qualitative organizational research: best papers from the davis conference on qualitative research 2006, 9–51. https://psycnet.apa.org/record/2016-25892-002 .

Manchha AV, Way KA, Tann K, et al. The social construction of stigma in aged-care work: implications for health professionals’ work intentions. Gerontologist. 2022;12(62):994–1005. https://doi.org/10.1093/geront/gnac002.PMID:35018434;PMCID:PMC9372892 .

Yau SY, Lee YK, Li SY, et al. The social construction of “Dirty Work” for working in residential care homes for the elderly In: Law, V.T.S., Fong, B.Y.F. (eds) Ageing with dignity in Hong Kong and Asia. Quality of life in Asia, vol 16. Springer, Singapore. https://doi.org/10.1007/978-981-19-3061-4_5

Scales K. Transforming direct care jobs, reimagining long-term services and supports. J Am Med Dir Assoc. 2022;23(2):207–13. https://doi.org/10.1016/j.jamda.2021.12.005 . Epub 2021 Dec 29 PMID: 34973168.

Yeatts DE, Seckin G, Shen Y, et al. Burnout among direct-care workers in nursing homes: Influences of organisational, workplace, interpersonal and personal characteristics. J Clin Nurs. 2018;27:3652–65. https://doi.org/10.1111/jocn.14267 . Epub 2018 Jul 17 PMID: 29322572.

Scales K, Bailey S, Middleton J, et al. Power, empowerment, and person-centred care: using ethnography to examine the everyday practice of unregistered dementia care staff. Sociol Health Illn. 2017;39:227–43. https://doi.org/10.1111/1467-9566.12524 . PMID: 27891628.

Clarke M, Ravenswood K. Constructing a career identity in the aged care sector: overcoming the “taint” of dirty work. Pers Rev. 2019;48(1):76–97. https://doi.org/10.1108/PR-08-2017-0244 .

Working Group on Elderly Services Programme Plan. Elderly services programme plan. 2017. https://www.elderlycommission.gov.hk/en/download/library/ESPP_Final_Report_Eng.pdf .

Chui EW. Long-term care policy in Hong Kong: challenges and future directions. Home Health Care Serv Q. 2011;30(3):119–32. https://doi.org/10.1080/01621424.2011.592413 . PMID: 21846226.

The Government of the Hong Kong Special Administrative Region. Hong Kong Yearbook 2022. 2022. https://www.yearbook.gov.hk/2022/en/pdf/E14.pdf .

Lum T, Shi C, Wong G, et al. COVID-19 and long-term care policy for older people in Hong Kong. J Aging Soc Policy. 2020;32(4–5):373–9. https://doi.org/10.1080/08959420.2020.1773192 . Epub 2020 May 31 PMID: 32476597.

Social Welfare Department. Navigation scheme for young persons in care services. 2023. https://www.swd.gov.hk/en/pubsvc/elderly/cat_ms_ita/nsypcc/ .

Labour and Welfare Bureau. Measure to increase and enhance manpower resources for the sector of residential care homes for the elderly. 2023. https://www.legco.gov.hk/yr2023/english/panels/ws/ws_rcp/papers/ws_rcp20230214cb2-98-1-e.pdf .

Franzosa E, Tsui EK, Baron S. “Who’s Caring for Us?”: understanding and addressing the effects of emotional labor on home health aides’ well-being. Gerontologist. 2019;59(6):1055–64. https://doi.org/10.1093/geront/gny099 . PMID: 30124808.

Schulte PA, Guerin RJ, Schill AL, et al. Considerations for incorporating “Well-Being” in public policy for workers and workplaces. Am J Public Health. 2015;105:e31-44. https://doi.org/10.2105/AJPH.2015.302616 . Epub 2015 Jun 11. PMID: 26066933; PMCID: PMC4504308.

Saunders B, Sim J, Kingstone T, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52:1893–907. https://doi.org/10.1007/s11135-017-0574-8 . Epub 2017 Sep 14. PMID: 29937585; PMCID: PMC5993836.

Doyle L, McCabe C, Keogh B, et al. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2022;25(5):443–55. https://doi.org/10.1177/1744987119880234 .

Elena L, Luminita V, Aurelia M. Multi-stage maximum variation sampling in health promotion programs’ evaluation. J Prev Med. 2007;15:5–18.

Google Scholar  

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101. https://doi.org/10.1191/1478088706qp063oa .

Braun V, Clarke V. Thematic analysis. In E. Lyons & A. Coyle (Eds.), Analysing qualitative data in psychology 2021. https://doi.org/10.1037/13620-004 .

Lincoln Y, Guba E. Naturalistic inquiry. USA: Sage Publications; 1985.

Book   Google Scholar  

White EM, Aiken LH, Sloane DM, et al. Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction. Geriatr Nurs. 2020;41(2):158–64. https://doi.org/10.1016/j.gerinurse.2019.08.007 . Epub 2019 Sep 3. PMID: 31488333; PMCID: PMC7051884.

Kemper P, Heier B, Barry T, et al. What do direct care workers say would improve their jobs? Differences across settings. Gerontologist. 2008;48 Spec 1:17–25. https://doi.org/10.1093/geront/48.supplement_1.17 . PMID: 18694983.

Matthews M, Carsten MK, Ayers DJ, et al. Determinants of turnover among low wage earners in long term care: the role of manager-employee relationships. Geriatr Nurs. 2018;39:407–13. https://doi.org/10.1016/j.gerinurse.2017.12.004 . Epub 2018 Feb 27 PMID: 29499899.

Simone SD. Conceptualizing wellbeing in the workplace. Int J Bus Soc Sci. 2014;5:118–22 https://ijbssnet.com/journals/vol_5_no_12_november_2014/14.pdf .

Scales K, Lepore MJ. Always essential: valuing direct care workers in long-term care. Pub Pol Aging Report. 2020;30:173–7. https://doi.org/10.1093/ppar/praa022 .

HKQF. Vocational qualifications pathway. 2019. https://www.hkqf.gov.hk/ecs/en/pathways/index.html .

Rockwell J. From person-centered to relational care: expanding the focus in residential care facilities. J Ger Soc Work. 2012;55:233–48. https://doi.org/10.1080/01634372.2011.639438 .

Ronch JL. Changing institutional culture: Can we Re-Value the nursing home?. J Ger Soc Work. 2004;43:61–82. https://doi.org/10.1300/J083v43n01_06 .

Kartupelis J. Relational care: improving lives for older people, carers and families. In making relational care work for older people. London: Routledge; 2020. p. 1–32.

Koren MJ. Person-centered care for nursing home residents: the culture-change movement. Health Aff (Millwood). 2010;29:312–7. https://doi.org/10.1377/hlthaff.2009.0966 . Epub 2010 Jan 7 PMID: 20056692.

Claeys A, Berdai-Chaouni S, Tricas-Sauras S, et al. Culturally Sensitive care: definitions, perceptions, and practices of health care professionals. J Transcult Nurs. 2021;32:484–92. https://doi.org/10.1177/1043659620970625 . Epub 2020 Nov 5 PMID: 33150857.

Negin J, Coffman J, Connell J, et al. Foreign-born aged care workers in Australia: a growing trend. Australas J Ageing. 2016;35:E13–7. https://doi.org/10.1111/ajag.12321 . Epub 2016 Jun 1 PMID: 27245976.

Willis E, Xiao LD, Morey W, et al. New migrants in residential aged care: managing diversity in not-for-profit organisations. J Int Mig Int. 2018;19(3):683–700. https://doi.org/10.1007/s12134-018-0564-2 .

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Acknowledgements

We should like to thank the health care workers for participating in the study and the superintendents of the residential care homes for the older people to recruit the participants.

The work described in this paper was fully supported by a grant from the Research Grants Council of the Hong Kong Special Administrative Region, China (UGC/FDS16/M12/20).

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Y.S.Y., L.Y.K.L., L.S.Y.B., L.S.P.S. and L.S.K.V. conceived the ideas for the research. H.S., L.S.Y.B., L.S.P.S. and L.S.K.V. collected the data. Y.S.Y. and H.S. analysed the data. H.S. led the writing with the help of Y.S.Y. All authors critically revised the manuscript for important intellectual content. All authors have approved the final version of the article.

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Yau, S.Y., Lee, Y.K.L., Li, S.Y.B. et al. Health care workers’ self-perceived meaning of residential care work. BMC Health Serv Res 24 , 766 (2024). https://doi.org/10.1186/s12913-024-11218-2

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Dr. Michelle Munson Partners on Center for Young Adults with Mental Illness

During their transition to adulthood, youth with serious mental health conditions can struggle to achieve education goals, secure stable housing, obtain employment, and form healthy relationships. This is particularly true for those in their mid-teens to late 20s from disadvantaged backgrounds, who face additional challenges, including poverty, discrimination and reliance on safety-net systems of care. To address this problem, NYU Silver Professor Michelle Munson is partnering with colleagues from the University of Massachusetts Chan Medical School and Temple University on a five-year, $4.3 million federally funded rehabilitation research and training center for marginalized young adults focused on enhancing community participation and overall quality of life and wellbeing. Dr. Munson, who has studied mental health services and interventions for over two decades, leads NYU Silver’s Youth and Young Adult Mental Health Group.

The new project, called the Community Inclusion and Reflective Collaboration Center (CIRC Center), aims to generate new knowledge about developmentally appropriate interventions, while addressing system and policy issues affecting community living and participation. It will also provide training and other assistance activities to transition-age youth with serious mental health conditions.

Dr Munson shared, “We know from decades of research that young people living with mental health conditions often experience isolation and can have difficulty living communally and participating in collective activities, and the CIRC center is focused on developing and testing strategies to improve these aspects of young adulthood, which are critical to quality of life.”

The CIRC Center encompasses five research studies and three training projects. Dr. Munson is the Center’s Senior Advisor on Community Engaged and Participatory Research and a Co-Investigator on two of the studies. The center’s Principal Investigators are Dr. Kathryn Sabella , Assistant Professor of Psychiatry at UMass Chan, and Dr. Elizabeth Thomas , Assistant Professor of Social and Behavioral sciences at Temple. The project is co-funded by the National Institute on Disability, Independent Living, and Rehabilitation Research and the Substance Abuse and Mental Health Services Administration.

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Research: Using AI at Work Makes Us Lonelier and Less Healthy

• David De Cremer
• Joel Koopman

Employees who use AI as a core part of their jobs report feeling more isolated, drinking more, and sleeping less than employees who don’t.

The promise of AI is alluring — optimized productivity, lightning-fast data analysis, and freedom from mundane tasks — and both companies and workers alike are fascinated (and more than a little dumbfounded) by how these tools allow them to do more and better work faster than ever before. Yet in fervor to keep pace with competitors and reap the efficiency gains associated with deploying AI, many organizations have lost sight of their most important asset: the humans whose jobs are being fragmented into tasks that are increasingly becoming automated. Across four studies, employees who use it as a core part of their jobs reported feeling lonelier, drinking more, and suffering from insomnia more than employees who don’t.

Imagine this: Jia, a marketing analyst, arrives at work, logs into her computer, and is greeted by an AI assistant that has already sorted through her emails, prioritized her tasks for the day, and generated first drafts of reports that used to take hours to write. Jia (like everyone who has spent time working with these tools) marvels at how much time she can save by using AI. Inspired by the efficiency-enhancing effects of AI, Jia feels that she can be so much more productive than before. As a result, she gets focused on completing as many tasks as possible in conjunction with her AI assistant.

• David De Cremer is a professor of management and technology at Northeastern University and the Dunton Family Dean of its D’Amore-McKim School of Business. His website is daviddecremer.com .
• JK Joel Koopman is the TJ Barlow Professor of Business Administration at the Mays Business School of Texas A&M University. His research interests include prosocial behavior, organizational justice, motivational processes, and research methodology. He has won multiple awards from Academy of Management’s HR Division (Early Career Achievement Award and David P. Lepak Service Award) along with the 2022 SIOP Distinguished Early Career Contributions award, and currently serves on the Leadership Committee for the HR Division of the Academy of Management .

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UNC-Chapel Hill in top 5 of The Princeton Review’s best value colleges

Carolina is second among public universities for financial aid.

The University of North Carolina at Chapel Hill is ranked No. 4 in The Princeton Review’s annual list of best public universities for value.

The college admissions service company considered several factors in compiling its list of 209 best-value schools, including academics, costs, financial aid, debt, graduation rates and alumni career and salary data. Lists were divided by public and private institutions. Carolina moved up from No. 7 in last year’s list.

Carolina also ranked second on the list of public universities for financial aid and No. 9 for best schools for making an impact. The latter is based on student survey responses to questions about community service opportunities, student government, sustainability efforts and on-campus student engagement.

“We are extremely proud of our ability to provide a high-quality and nationally competitive education while remaining affordable and accessible,” said Interim Chancellor Lee H. Roberts. “Our goal is to ensure that each of our outstanding students can gain a college degree without the burden of college debt. This recognition by The Princeton Review is reflective of our hardworking and dedicated faculty and staff, our generous donors and the exceptional longstanding support of North Carolina’s taxpayers.”

Last fall, U.S. News & World Report ranked UNC-Chapel Hill as the No. 4 public university in the country and No. 22 overall.

Those with an active UNC-Chapel Hill email can get a free July GoPass for GoTriangle bus routes.

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