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Skills of the 'information age' need to be applied to social work. Conceptual and practical aspects of using online bibliographic databases to identify research were explored using multi-professional decision-making in child protection as a case study. Five databases (Social Science Citation Index, Scopus, Medline, Social Work Abstracts and Cochrane Central Register of Controlled Trials) were searched for relevant studies, retrieving 6,934 records of which fifty-eight studies were identified as relevant. The usefulness of specific search terms and the process of learning from the terminology of previous searches are illustrated, as well as the value of software to manage retrieved studies. Scopus had the highest sensitivity (retrieving the highest number of relevant articles) and retrieved the most articles not retrieved by any other database (exclusiveness). All databases had low precision on this topic, despite extensive efforts in selecting search terms. Cumulative knowledge about search strategies and empirical comparison of database utility helps to increase the efficiency of systematic literature searching. Such endeavours encourage and support professionals to use the best available evidence to inform practice and policy. [ABSTRACT FROM AUTHOR]

Social workers are frequently involved in making decisions and in managing risks, although there has been limited conceptualisation to connect these tasks with each other or with assessment processes. This lack of connection reflects the general separateness of the wider academic discourses on risk and uncertainty (often sociological and organisational, relating frequently to business or economic contexts) and those on decision-making (often focusing on psychology of individual judgement, and typically relating to medical or military contexts). This article presents and explores the potential of a 'risk-managing decision model', as an example of a model linking risk management with decision science. This is a psycho-social rationality model for choosing between options, such as possible care, support or intervention plans for a client or family. Rather than treating the options as 'given' (i.e. unchangeable), as in most decision theories, this model proposes that the decision maker(s) look for ways to manage or reduce the risks inherent in the preferred option as part of the decision process. Like other psycho-social rationality models, this model incorporates both individual cognitive dimensions and framing aspects of the decision environment. Relevance to social work is discussed with examples and reference to various settings and decision processes. [ABSTRACT FROM AUTHOR]

Communicating effectively about risk is fundamental to professionals addressing critical issues with clients and families, and to informed decision making. Using a grounded theory approach, this qualitative study explored how risk is conceptualised and communicated in dementia care. Data were gathered across five focus groups (thirty-five health and social care professionals) covering concepts and perspectives on verbal, numeric and visual forms of communicating risk. Risks were primarily conceptualised as consequences (positive and negative) rather than as likelihood, and related to a wide range of domains. Perceptions were influenced by socio-cultural factors including risk-assessment mechanisms and wider discourse relating to positive risk taking. The language of probability was used in a nonquantified, subjective manner. While professionals routinely received quantitative information, they did not typically communicate using numeric expressions. Verbal expressions of likelihood were widely preferred to numeric. When risks were presented in numeric formats, frequency presentation was seen as more comprehensible than percentages. Several participants saw potential in visual forms of risk communication. Bar charts were generally favoured over icon arrays as more easily understood. Good practice examples for risk communication were identified. This study provides pointers towards further research to support optimal risk communication in the complex domain of community care. [ABSTRACT FROM AUTHOR]

There is increasing attention to decision making in social work as we become more concerned about 'risk' and the most effective design of assessment tools to aid professional judgement. In order to develop practice, a better conceptual understanding is required of the cognitive processes in making these judgements. This paper explores the potential use of heuristic (small-scale, 'rule-of-thumb') models of cognitive judgement in social work, recognising that human beings (including social work professionals) cannot simultaneously process large numbers of factors with associated statistical weightings. This paper discusses heuristic models of professional judgement based on a proposed concept of psycho-social rationality. Such heuristic models would take account of the psycho-social environment in which the decision is being made as well as of the cognitive processes of the decision maker. The potential application to professional judgement in social work is discussed with reference to examples of various types of social work decision. Potential issues in developing and adopting this theoretical approach in practice are raised--including legal dimensions and potential bias--and the implications for social work research are discussed. [ABSTRACT FROM AUTHOR]

Background: The implantable cardioverter defibrillator (ICD) is a cornerstone in the treatment of life-threatening arrhythmias. As rates of device implantation continue to rise throughout Europe, European and International guidelines recommend professionals discuss deactivation with patients. In reality the appropriate therapeutic management of an ICD at the end-of-life remains uncertain in the minds of professionals and patients. Aim: To identify current practice and examine professional decision-making for patients with an ICD from time of implantation to final documentation and demise. Methods: Retrospective case note review of patients with an ICD who died during a 12 month period at a regional implantation centre. Results: Fifty-nine patients were identified and medical notes of 44 of these patients were successfully retrieved. The majority of patients were male, mean age at time of death 73 years with one-third diagnosed with a malignancy prior to death. There was no documented evidence patients were informed about deactivation prior to ICD implantation. End-of-life management was discussed with 23 patients and on 17 occasions deactivation was included. Median time from discussion to death was seven days. In total 62.5% of patients who experienced a shock had an active ICD at death, while 93.7% who had their ICD deactivated never had a shock (p=0.003). Conclusion: Patients were not adequately informed regarding device deactivation prior to implantation, nor when their health deteriorated. The experience of a shock potentially affects professional decision making regarding device deactivation. [ABSTRACT FROM AUTHOR]

Current global concerns regarding the mental well-being (MWB) of young males have called for fresh approaches to social work service delivery. This study investigates the efficacy of adopting more 'online' approaches within social work practice by examining the current impact of online help-seeking behaviours on the MWB of adolescent males. A survey questionnaire comprised of validated scales measuring mental well-being and self-efficacy, combined with questions examining online help-seeking attitudes and behaviours was completed by 527 respondents aged 14-16 years with in a school environment. The internet was used by 42 per cent of respondents to retrieve health information. In general, respondents appeared knowledgeable regarding the importance of trusted and quality online health information, yet were more likely to use search engines (57 per cent) or social networking sites (48 percent) to find information rather than a government-sponsored website (23 per cent). Young males who reported speaking to online friends regarding personal problems recorded statistically significantly higher levels of mental well-being (p, 0.02). This may suggest that being able to communicate online how you are feeling is a positive for male mental health. Social work practitioners need to recognise this generational shift in help-seeking, in terms of providing and commissioning interpersonal helping via social media. [ABSTRACT FROM AUTHOR]

Assessment is central to identifying needs, making decisions and providing services. Assessment tools have a role in relation to co-ordinating care, communication between professionals and gathering data for monitoring and service improvement. As the health and social care of older people becomes more complex, there is an increased requirement for co-ordinated, effective and efficient assessment. This paper outlines the development of the Northern Ireland Single Assessment Tool (NISAT) for the health and social care of older people. The development involved stakeholders from a wide range of professions, older people and carers. The process included a survey of existing care management assessment tools, various working groups and testing reliability using vignettes and trained actors. Older people were engaged in a music, dance and visual arts project on the theme of assessment to inform the tool development. The components of the tool and their development are reviewed, including considering the role of social work in contributing to specialist assessment as distinct from the role of co-ordinating a holistic assessment process. There are challenges facing co-ordinated assessment processes in health and social care of older people because of the wide variety of care pathways in primary, acute, ‘intermediate’ and community care settings. [ABSTRACT FROM PUBLISHER]

Guidance in the UK requires the co-ordination and standardisation of services to protect adults from abuse. However, there remains considerable ambiguity about the basic concepts of abuse and vulnerability. This paper reports an empirical study of factors in professional decision making in relation to identifying and reporting abuse of older people. A systematic review and a panel of expert practitioners were used to identify factors that might influence professional recognition and reporting of elder abuse. These factors were incorporated into a questionnaire that included randomised factorial survey vignettes and additional questions on decision making. Sets of unique vignettes were completed by 190 social workers, nurses and other professional care managers across Northern Ireland in 2008, giving 2,261 randomised vignettes used as the units of analysis. Recognition and reporting were influenced by case factors specific to the abuse event while contextual factors did not significantly influence recognition or referring of abuse. This study has shown that the factorial survey can be a powerful tool to investigate professional decision making. It provides an insight into practitioners' responses to complex ethical dilemmas. The findings are considered within the context of current policy and the need for further research is discussed. [ABSTRACT FROM AUTHOR]

The impetus towards basing practice and policy decisions more explicitly on sound research requires tools to facilitate the systematic appraisal of the quality of research encompassing a diverse range of methods and designs. Five exemplar tools were developed and assessed in terms of their usefulness in selecting studies for inclusion in a systematic review. The widely used 'hierarchy of evidence' was adapted and used to appraise internal validity. Four tools were then developed to appraise the external validity dimensions of generalizability (two scales) and methods of data collection (two scales). Methods of combining the scores generated by each tool were explored. Qualitative and quantitative studies were appraised, not separated into two spheres but by using complementary tools developed to appraise different aspects of rigour. There was a high level of agreement between researchers in applying the tools to twenty two studies on decision making by professionals about the longterm care of older people. The scales for internal validity and generalizability discriminated between the qualities of studies appropriately. The two tools to appraise data collection gave diverse results. Excluding studies that scored in the lowest category on any scale appeared to be the scoring system that was most justifiable. This approach is presented to stimulate debate about the practical application of the evidence-based initiative to social work and social care. This study may assist in developing clearer definitions and common language about appraising rigour that should further the process of selecting robust research for synthesis to inform practice and policy decisions. [ABSTRACT FROM AUTHOR]

Risk management systems and structures are developing rapidly within UK health and personal social services. However, the risk management strategies of organizations need to take into account the conceptual frameworks used by professionals. This grounded theory study used data from nineteen focus groups and nine semi-structured interviews (ninety-nine staff in total) to explore perspectives on risk and decision-making regarding the long-term care of older people. Focus group participants and interviewees comprised social workers, care managers, consultant geriatricians, general medical practitioners, community nurses, occupational therapists, home care managers and hospital discharge support staff. Social work and health care professionals conceptualized risk and its management according to six paradigms that appeared to be in a state of reciprocal tension: (i) Identifying and Meeting Needs; (ii) Minimizing Situational Hazards; (iii) Protecting this Individual and Others; (iv) Balancing Benefits and Harms; (v) Accounting for Resources and Priorities; and (vi) Wariness of Lurking Conflicts. The effective translation into practice of risk management strategies needs to address the complex and often contradictory issues facing health and social services professionals. [ABSTRACT FROM AUTHOR]

Decision making is becoming an increasingly central feature of social work practice, yet there is limited research on the topic. Experimental methods of investigating decision making tend to be constrained by practical and ethical difficulties, whilst questions about validity and generalizability surround ethnographic and other descriptive methods. It is argued here that the factorial survey addresses these methodological difficulties as a research design to study the way that professionals make decisions in real life. In this research design, true-to-life vignettes (case scenarios or paper cases) are presented to social workers or other staff to make a judgement about a familiar type of scenario. The randomized factors within the vignettes, combined with the randomization of the selection of vignettes for each decision maker, give the factorial survey a unique capability to investigate the effect of multiple factors in complex decisions, unlike the more common factorial experiment. The method is explained, and prospects and issues for the development of this research design to study professional judgement within social work are discussed. The factorial survey has potential as a method for rigorous study of the impact of client, family and context factors on decisions by social work and social care staff. INSET: An example of a vignette used in a factorial survey. [ABSTRACT FROM AUTHOR]

With the increasing pressure on social and health care resources, professionals have to be more explicit in their decision making regarding the long-term care of older people. This grounded theory study used 19 focus groups and nine semi-structured interviews (99 staff in total) to explore professional perspectives on this decision making. Focus group participants and interviewees comprised care managers, social workers, consultant geriatricians, general medical practitioners, community nurses, home care managers, occupational therapists and hospital discharge support staff. The emerging themes spanned context, clients, families and services. Decisions were often prompted by a crisis, hindering professionals seeking to make a measured assessment. Fear of burglary and assault, and the willingness and availability of family to help were major factors in decisions about living at home. Service availability in terms of public funding for community care, the availability of home care workers and workload pressures on primary care services influenced decision 'thresholds' regarding admission to institutional care. Assessment tools designed to assist decision making about the long-term care of older people need to take into account the critical aspects of individual fears and motivation, family support and the availability of publicly funded services as well as functional and medical needs. [ABSTRACT FROM AUTHOR]

Context: Electronic bibliographic databases are an important source for professional publications about social work and community care more generally. This article describes and evaluates a method of identifying relevant articles as part of a systematic review of research evidence. Decision making about institutional and home care services for older people is used as an example. Method: Four databases (Social Science Citation Index, Medline, CINAHL and Caredata), which abstract publications relevant to health and social services, were searched systematically to identify relevant research studies. The items retrieved were appraised independently using a standard form developed for the purpose. The searches were compared in terms of sensitivity, precision, overlap between databases and inter-rater reliability. Results: The search retrieved 525 articles, of which 276 were relevant. The four databases retrieved 55 per cent, 41 per cent, 19 per cent and 1 per cent of the relevant articles respectively, achieving these sensitivities with precision levels of 54 per cent, 48 per cent, 84 per cent and 94 per cent. The databases retrieved 116, 73, 24 and 15 unique relevant articles respectively, showing the need to use a range of databases. Discussion: A general approach to creating a search to retrieve relevant research has been developed. The development of an international, indexed database dedicated to literature relevant to social services is a priority to enable progress in evidence-based policy and practice in social work. Editors and researchers should consider using structured abstracts in order to improve the retrieval and dissemination of research. [ABSTRACT FROM AUTHOR]