The Need for Social Worker Training in Some Hospitals in Hanoi 2024 Volume 59- Issue 1

Pham Tuong Van*, Tran Thi Thanh Huong

• Hanoi Medical University, 1 Ton That Tung, Vietnam

Received: October 09, 2024; Published: October 17, 2024

*Corresponding author: Pham Tuong Van, Hanoi Medical University, 1 Ton That Tung, Dong Da District, Hanoi Vietnaml

DOI: 10.26717/BJSTR.2024.59.009250

Abstract PDF

ABSTRACT

Objectives: Assess the need for training for social workers at some hospitals in Hanoi 2024.

Methods: A cross-sectional descriptive study was conducted on medical staff at Bach Mai Hospital, National Cancer Hospital and National Children's Hospital. Data were collected based on the toolkit developed according to Circular 43/2015/TT-BYT and Decision 32/2010/QD-TTg on developing social work in hospitals.

Result: Training needs: 53.7% of staff believe that social work in hospitals is very vital. Tasks such as welcoming, assisting patients, and providing information are highly valued. Required competencies: knowledge of law, social psychology, and social work methods are considered very important (42.1%).

Training Methods: Staff prefer to learn through presentations (55.7%), case studies (40.5%), and online learning (34.2%).

Conclusion: There is a huge demand for social work training in hospital (53.8%), especially in areas such as palliative care (37.5%), psychological counseling and patient support (28.7%). University (78.5%) resources are preferred. Most desired teachers are social work postgraduates.

Recommendation: Enhancing healthcare social work training, particularly in palliative care and psychiatric counseling. Developing and consolidating hospital social work departments with sufficient personnel and financial resources. Multiple instructional approaches and better teachers.

Keywords: Social Work; Hospital; Medical Staff; The Needs; Training; Hanoi

Introduction

The importance of social workers (SW) in the health system is recognized and developed worldwide. SWs help patients and their families access health services and improve treatment in hospitals. US and European studies show that SWs improve healthcare by providing psychological and social counseling and reducing patient stress [1]. To join the American Hospital Association (AHA), US hospitals must have a social work department, demonstrating its importance in the health system [2]. In Vietnam, hospital social work is growing but has several problems, especially professional competence. In Doan Kim Thang (2021)'s study at the National Children's Hospital and the Hanoi Traditional Medicine Hospital, SWs provided procedural support to 21.5% of patients and 13.2% in emergencies [3]. Pham Tien Nam's research also demonstrates that Vietnamese hospital SW teams are undertrained, restricting their ability to help different patients [4]. Patients with high support needs are common in Hanoi's main hospitals. This study examines 2024 Hanoi hospital social worker training needs. It tries to identify SW professional competency gaps and guide SW workforce development to meet rising healthcare demands.

Methods

Research Subject

The study focuses on medical staff at several hospitals in Hanoi, as they are the group that interacts directly with social workers the most.

Inclusion Criteria: Medical staff agreed to participate in the study. Medical staff with at least 6 months or 1 year of experience in their department/ward. Staff working at the hospital during the study period

Exclusion Criteria: Staff on maternity leave, long-term leave, unpaid leave, or long-term study.

Study Duration and Location

Duration: Form October 2023 to October 2024.

Location: Selected departments at Bach Mai hospital, National Cancer Hospital, Viet Nam National Children's Hospita, Hanoi.

Study Design

A cross-sectional descriptive design was used

Sample Size and Technique

Where:

n: required sample size.

Z 1-α/2: 1.96 for 95% confidence level.

p = 0.5: estimated proportion (to maximize sample size).

d = 0.1: allowable margin of error.

Based on this formula, the required sample size is 97. To allow for a 10% loss, the sample size is increased to 121.

Sampling Method: Randomly select three departments from each hospital, prioritizing departments with the highest number of healthcare staff. The 121 samples are proportionally distributed across hospitals, with larger hospitals having more samples.

Evaluation Tools and Methods

Tools were developed based on Circular No. 43/2015/TT-BYT of the Ministry of Health and Decision No. 32/2010/QĐ-TTg by the Prime Minister approving the “Social Work Profession Development Project in Vietnam, 2010-2020” [5,6].

Data Analysis and Processing

Data will be processed and analyzed using Excel with descriptive statistics.

Research Ethics

The study only involves observation and interviews without direct interference in healthcare workers' duties. Participants will complete self-assessment surveys via Google Forms, and assistance will be provided when necessary. Results will be shared with hospital/department management after the study concludes.

Result

Describe General Information About the Research Subject

(Tables 1-5).

Note: Comments: The youngest is 22 and the oldest 65, with an average age of 34.5. The majority are female (76%), while males account for 24%. National Children’s Hospital has the highest participation rate (37.2%), while K Hospital has the lowest (28.1%). The highest proportion of participants has over 10 years of experience (34.7%), and 33.1% do not participate in social work. Most staff are nurses (32.2%), doctors (30.6%), and social workers (29.8%). Many earned nursing degrees (29.8%) and master’s (16.5%). Over 50 patients (28.9%) have the highest contact rate, with 43.8% having 15-30 minutes.

Note: Comments: Most questioned units reported a high demand for social work (SW) graduates in healthcare. The highest agreement rates were for the following activities: the necessity of SW in hospitals (53.7%), demand for human resources (51.2%), organizing SW departments (49.6%), and building a workforce for SW departments (48.8%). The “strongly agree” rates were 28.9%, 23.1%, 26.4%, and 26.4%, respectively. Some disagreed, with 11.6%, 13.3%, 15.7%, and 15.7% for the issues.

Note: Comments: The table demonstrates healthcare facility social work demand, with 33.1% saying welcome, directing, and providing medical service information is very necessary. Additionally, 33.1% stressed the importance of rights and health insurance policy consultation. 35.5% think emergency support for abuse victims is essential, while 9.9% do not. Discharge support and referrals are 53.7% necessary. Volunteer coordination is needed by 54.5%, and health communication and education by 57%. Service introduction and SW guidance had 51.2%–56.2% need rates. However, 10.7% said giving medical workers patient information was unnecessary, while 30.6% thought it was essential.

Note: Comments: Most respondents viewed knowledge as essential or very useful for social work graduates. Legal and psychological expertise were crucial for 42.1%. The application of professional social work expertise was important for 43% and very necessary for 40.5%. 42.1% said patient support analysis and planning was required, while 5.8% and 7.4% did not. 42.1% considered research and support models necessary, 41.3% very necessary, and 3.3% uncertain. Professional responsibility was very required for 43.8%, necessary for 41.3%, unsure for 1.7%, and unneeded for 6.6%.

Note: Comments: The most desired training content for healthcare workers is social work in hospitals (53.8%), palliative care for cancer patients (37.5%), psychological counseling (28.7%), and individual counseling (21.3%). From 10 to 26.3% of social work is with organizations, the elderly, the impoverished, special needs children, and trafficking victims. Teaching techniques preferred were lectures (55.7%), case studies (40.5%), and the Internet (34.2%). University (78.5%), Ministry of Labor (43%), and NGO (27.8%) resources are preferred. Most desired teachers are social work postgraduates (68.8%) and psychology/sociology (55%).

Discussion

Data shows that 53.7% agree the importance of training social work graduates in hospitals and 48.8% believe social work departments should be created. In industrialized countries like the U.S. and Europe, social workers in healthcare improve patient care, particularly psychological and social assistance [1]. The American Hospital Association requires hospitals in the U.S. to have social work departments [2]. Social workers in community healthcare broaden the network and encourage them to handle health concerns using suitable skills and strategies. Most Singaporean and Filipino hospitals have social work departments [2]. To acknowledge the importance of social work in hospitals, the Vietnamese Prime Minister announced Decision No. 32/2010/QĐ-TTg on March 25, 2010, approving a project to develop the profession from 2010 to 2020 [1]. The Ministry of Health approved a 2011 project to improve social work in healthcare to create a welcoming and effective workplace [6].

Additionally, Circular 43/2015/TT-BYT establishes hospital social work roles and organizations. This shows that the Party, State, and various levels of government are increasingly focusing on hospital social work [7]. Nguyen Thi Hang Phuong and colleagues (2021) published "Introduction to Social Work," a textbook on social work and hospital social work, providing an overview of global and Vietnamese social issues and laying the groundwork for social workers to shape and understand the profession [7]. Author Dang Kim Khanh Ly (2011) clarified personal and communal ties in hospitals [8]. Hospital social work research and development are popular worldwide and in Vietnam. However, 11.6% still don't appreciate or support hospital social work. Some people may not understand social work's relevance. In a 2019 survey of 500 hospitals nationwide, Pham Tien Nam and colleagues found that 100% of central hospitals, 96.14% of provincial hospitals, and 88.65% of district hospitals had social work departments or units. Only 64.29% of central, 44.22% of provincial, and 25.2% of district hospitals had full-time social workers.

Only a few people were trained in sociology and psychology, whereas most were hospital workers reassigned to social work [9]. Financial and staffing issues make hospital social work departments/units difficult to establish and maintain. According to research by Ngo Anh Minh at Phu Tho General Hospital, money is crucial for the success of social work initiatives. Social work is more successful in hospitals with supportive leadership, high-quality staff, and enough investment [10]. Nguyen Thi Thanh Tung confirms that 30.8% of social workers are unsatisfied with their pay [9]. Many social work or allied majors avoid hospital social work units for this reason. Social work is unattractive due to its high workload, low pay, and little career advancement chances. Training programs, improved knowledge of social work, and management support in allocating resources and funds to build a sustainable working environment and improve healthcare efficacy are needed to solve this issue. The study found that most respondents understand social work (SW) in healthcare facilities, including supporting and advising patients and their families, communicating, and fundraising. However, 9.9% still undervalue social work, calling it "very unnecessary."

According to a study by Lý Tiểu Long at Phạm Ngọc Thạch Hospital, only 4.89 percent of healthcare workers had strong social work expertise, while the majority had average (20.98%) or low (74.13%) understanding. However, 52.21% had a positive opinion toward hospital social work and 51.29% behaved appropriately [11]. A study by Duong Thi Minh Thu found that 48.9% of healthcare workers in acute, chronic, and intensive care departments at the National Children's Hospital had average social work knowledge, but 80% had a positive attitude and 75.6% exhibited appropriate behavior when interacting with social workers [11]. Sample size, target group, and research location may explain study variances. This highlights the need for more research and social work training to improve healthcare staff' understanding and conduct, increasing patient care and support.

Social workers must know law, social psychology, and human behavior, with 41.3% believing it necessary and 42.1% highly necessary, according to the survey. Additionally, 42.1% believe social workers must have research expertise and be able to build intervention strategies to aid people with life problems. Meanwhile, 43% believe social workers must be able to apply psychology, sociology, social work ideas and models, and professional procedures. According to 42.1%, expertise is needed to analyze, plan, and implement patient solutions. In particular, 43.8% agree that social work graduates must be responsible and follow professional ethics, which is crucial to their employment. This finding is similar to a 2014 Australian study that found hospital social workers need legal healthcare system and patient rights knowledge, crisis management abilities, and human behavior knowledge to provide counseling and psychological support [12].

The National Association of Social Workers (NASW) in the U.S. also reported that social workers need legal knowledge and research abilities, notably in patient rights and health insurance legislation. The main difference is that NASW promotes interdisciplinary collaboration with healthcare and mental health specialists to create patient care plans [13]. The study also found that social workers must follow professional ethics and base their ethical decisions on the NASW Code of Ethics [13]. Healthcare workers (HCWs) want to train in hospital social work, palliative care for cancer patients, psychological counseling, and individual counseling, according to a survey. In contrast to Nguyen Trung Hai's study, 57.4% of staff believe patient psychology training vital, while 54.1% acknowledge the significance of understanding patients' difficulties [14]. HCWs typically work in hospital social work and palliative care, which may increase their requirement for knowledge and abilities in these areas.

Conclusion

Social work training is valued in healthcare, with 53.7% saying hospitals need it. 51.2% support social work staff, 49.6% support social work departments, and 48.8% support staffing them. Regarding social work tasks, 33.1% find welcoming and providing medical service information very necessary, while 53.7% consider discharge support and referrals important. Health communication and education are important to 57%, while 35.5% value emergency support for abuse victims. Regarding social work graduates' competencies, 42.1% find legal and psychosocial knowledge very necessary, and 43% consider the application of social work necessary. Professional responsibility and ethics in social work are highly valued by 43.8%. Healthcare workers want to take hospital social work (53.8%), cancer palliative care (37.5%), and psychological counseling (28.7%) courses. They prefer lecture-based teaching (55.7%), case studies (40.5%), and online learning (34.2%). Most preferred teachers have postgraduate degrees in social work (68.8%) and psychology/ sociology (55%).

Recommendation

Increase social worker professional training: Bachelor's programs in social work should emphasize on palliative care, psychiatric consulting, and social work with specific patient populations. Establish and consolidate hospital social work departments: Social work departments should have enough staff and resources to welcome, inform, and support patients and their families. Create specialized social work training: This program should cover legal, psychological, and practical social work abilities. Training must include ethics and professional standards. Presentations, case studies, and online learning should be used to fulfill healthcare staff's different learning needs. To assure high-quality training, employ teachers with postgraduate degrees in social work and related subjects like psychology and sociology.

References

1. (2021) Proceedings of the Scientific Conference on Social Work Services in Hospitals. University of Labor and Social Affairs, Campus II.
2. Ngo, Minh Anh (2019) Social work model from the practice of Phu Tho Provincial General Hospital. University of Labor and Social Affairs.
3. Doan, Kim Thang, Vietnam Academy of Social Sciences (2022) “Social work activities in hospitals today.” Vietnam Journal of Family and Gender Studies 32(2).
4. Pham, Tien Nam (2021) “Status of training a bachelor degree in hospital social work at the Hanoi University of Public Health: Some recommendations.” Journal of Science Educational Science 66(1).
5. Pham, Tien Nam, et al. (2020) “Hospital Social Work in Vietnam: Achievements and Challenges.”
6. (2014) Report on the implementation of Decision 32/2010/QD-TTg on the development of social work profession in Vietnam. Published online.
7. Tung, Nguyen Thi Thanh (2020)“Current situation to developing the social work profession in hospitals in Ho Chi Minh City.” Science & Technology Development Journal - Social Sciences & Humanities 4(1).
8. Duong, Thi Minh Thu (2020) “Knowledge, attitude, and behavior of health workers on social work profession at Vietnam National Children’s Hospital.” Journal of Health Research and Development 4(1).
9. Pham, Thi Kieu Duy, Thi Hang Phuong Nguyen, Da Nang, et al. (2021) Introductory social work textbook. Edited by University of Education Faculty of Psychology Educatio.
10. (2015) Ministry of Health. Circular regulating the tasks and forms of organization of implementation of social work tasks of hospitals.
11. Ly, Tieu Long, et al. (2023) "Knowledge, attitudes, and behaviors of health workers on social work at Pham Ngoc Thach Hospital in 2022." Journal of Public Health 62(03): 46-58.
12. Cleak HM, Turczynski M (2014) Hospital Social Work in Australia: Emerging Trends or More of the Same?. Social Work in Health Care 53(3): 199-213.
13. NASW Standards for Social Work Practice in Health Care Settings. www.socialworkers.org/Practice/NASW-Practice-Standards-Guidelines/NASW-Standards-for-Social-Work-Practice-in-Health-Care-Settings.
14. Nguyen, Trung Hai (2018) “Need for social work training in hospitals.” Vietnam Women's Academy Science Journal 3: 56-66.