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The important aspects of the function and purpose of social work

Patients with long-term psychosocial illnesses benefit from treatment plans that establish treatment goals [ 41 ]. For Michalak and Holthforth [ 42 ], treatment goals should be formulated with the patient, a strategy that makes it more likely that long-term target specific and measurable goal will be achieved within a given time.

That is, a good psychosocial care plan benefits all patients regardless of the origin of their problems. Developing treatment goals with patients encourages them to become actively involved in their treatment. Although some of the psychosocial problems of our participants were difficult to treat, all the patients seemed to benefit from establishing treatment goals. However, this study did not focus on disease duration or aggressiveness of the disease, two factors that could influence outcomes.

The present study indicates that RA patients also experience problems in areas that are not directly linked to the disease. So far, our results cannot be said to be very controversial.

  1. Musculoskeletal Care 2015; 13. The present study indicates that RA patients also experience problems in areas that are not directly linked to the disease.
  2. Clinical assessment of the 1987 American College of Rheumatology criteria for rheumatoid arthritis.
  3. Psychosocial problems among newly diagnosed rheumatoid arthritis patients. Social work in healthcare has been established for more than 100 years and has developed into a major sector of the profession in countries around the world.
  4. The present study indicates that RA patients also experience problems in areas that are not directly linked to the disease.
  5. This study suggests that social work in healthcare is most successful with people whose problems originate from the disease and whose daily life problems were related and were affected by the disease.

On the contrary, they are very much in line with what other studies have concluded [ 44 ]. Our results can be related to what has come to be a central question when it comes to equality in living conditions: We found that some patients reported RA-related problems in their employment situation.

This problem has been described before from a patient perspective on work-related dilemmas in early RA. Work-related dilemmas represented different societal perspectives on work related to acquiring, keeping, and terminating a job. Work dilemmas also represented participation priorities in economic self-sufficiency, self-care such as attending to treatment and healthcareand avoiding social relationships and recreation in favour of work. Leisure time was influenced because work took energy and time, two resources these patients lacked [ 47 ].

Patients who identified mixed problems found that their RA issues were complicated by their pre-diagnosis life situation especially as it related to psychological, family or economic problems. Having experienced multi-problems earlier in life influences the possibility of recovery i. None of the patients that experienced four to five mixed problems described suffering from a crisis reaction. Of these situations, half of the problems concerned RA and half were related to a pre-existing strained living situation.

The diagnosis and an already strained living situation seemed to mediate and complicate rehabilitation and adaptation. Most of the patients 14 of 17 who understood their problems as of a combined origin reported that they had experienced family problems even before the diagnosis of RA, and these kinds of problems were not as usual in any of the other groups.

Even if the RA diagnosis caused a further strain on the existing fragile and strained life situation within the family, the RA diagnosis was seen as just another aspect of their already difficult situation.

After two years of psychosocial treatment, most of the established treatment goals were achieved among individuals whose mixed problems were directly related to the newly diagnosed RA. Individuals who reported problems due to a combination of RA and life situation also benefited from the psychosocial treatment, but to a lesser extent. For the patients experiencing mixed problems due to a life situation, a few believed their treatment goals were achieved.

For these patients, the disease in itself may not have been the main problem as RA may have only been an additional source of stress in an already strained life situation. Targeting goals and goal setting are effective components of treatment in long-term illness [ 41 ].

The Importance of Social Work in Healthcare for Individuals with Rheumatoid Arthritis

Michalak and Holthforth [ 42 ] argue that when targeting long-term specific goals that are achievable within a given time, the goals need to be formulated by the patient. A measurable and objective goal has been shown to affect a patient's willingness to become actively involved in treatment.

Although a healthcare professional might define a patient's problems related to rehabilitation, recovery, and adaption to society, patients need to define their treatment goals. Even within healthcare the understanding of diseases differs as either essentially biomedical or social or psychological [ 29 ].

  • Krishnan E, Fries JF;
  • Medical treatment for patients with early RA has improved dramatically as a result of early interventions with diseasemodifying anti-rheumatic drugs DMARDs and new biological medications [ 10 ];
  • However, this study did not measure disease duration and aggressiveness nor did it weigh the experienced mixed-problems;
  • International classification of functioning, disability and health.

The present study indicates that patients with RA experiencing mixed-problems of a combined origin were more difficult to treat successfully in terms of achieving treatment goals.

However, this study did not measure disease duration and aggressiveness nor did it weigh the experienced mixed-problems.

The results of this study found that RA patients with diseaserelated mixed-problems should be given priority and the help they receive should be based on achievable treatment goals Figure 1. On the other hand, some patients with combined problems might need to be transferred to social workers or psychologists with areas of expertise other than medical social work.

This study suggests that social work in healthcare is most successful with people whose problems originate from the disease and whose daily life problems were related and were affected by the disease. We found that psychosocial treatment goals seem to be easiest to achieve among RA patients with disease-related problems.

The results of this study highlighted the effect of psychosocial treatment in medical social work for patients with early RA and who experience diseases related to psychosocial problems. Similarly, Dorstyn et al.

However, social work resources in the hospital setting are often limited and need to be used as efficiently as possible. In addition to specific professional knowledge, medical social workers need to have some knowledge in the medical field their clients require. Social work in healthcare has been established for more than 100 years and has developed into a major sector of the profession in countries around the world.

As a part of the larger social service system and healthcare system, medical social workers are also affected by changes in national and local economics, political power and philosophy, and technology in the larger environment [ 5051 ].

Medical treatment for patients with early RA has improved dramatically as a result of early interventions with diseasemodifying anti-rheumatic drugs DMARDs and new biological medications [ 10 ]. However, the patients in the present study were treated before this new RA medication, so the positive effect cannot be explained by improved medical treatment, but rather by the psychosocial treatment received shortly after the RA diagnosis.

One limitation of the study is of course to discuss about the new effective drugs against RA also affected the individual's problem clusters. To discuss this need a new study, conducted which studies differences and similarities in terms of clusters of problems before and after the DMARDs and new biological medications.

Conclusion In conclusion, we found three different types of mixedproblems in this sample of RA patients: The patients also had different types and collection of problems irrespective of the degree of difficulty or frequency of the problems.

We also found that RA patients who reported multi-problems at time of the diagnosis received psychosocial treatment from a medical social worker irrespective of the mixed problems they experienced and that the disease-related mixed problems seem more treatable than the other problems.

Based on the results of our study, it could be argued that mixed problems related to a chronic disease seem easier to manage than problems without a specific origin. Therefore, social work in somatic healthcare is most successful in patients with sicknesses related to social and psychosocial problems.

Declaration of Interest The authors report no conflict of interest. The study was financially supported by the Swedish Rheumatism Association.

References Miller Fitzergald J. Coping with chronic illness: FA Davis, cop, Philadelphia 2000. What is social case work? Russel Sage Foundation, New York 1922.

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  • Individuals who reported problems due to a combination of RA and life situation also benefited from the psychosocial treatment, but to a lesser extent;
  • For these patients, the disease in itself may not have been the main problem as RA may have only been an additional source of stress in an already strained life situation;
  • Work-related dilemmas represented different societal perspectives on work related to acquiring, keeping, and terminating a job;
  • International classification of functioning, disability and health;
  • Although a healthcare professional might define a patient's problems related to rehabilitation, recovery, and adaption to society, patients need to define their treatment goals;
  • For the patients experiencing mixed problems due to a life situation, a few believed their treatment goals were achieved.

Ann Rheum Dis 2011; 70: Sick leave before and after diagnosis of rheumatoid arthritis: J Rheumatol 2009; 36: Consequences of rheumatoid arthritis for performance of social roles: J Rheumatol 2007; 34: Psychosocial problems among newly diagnosed rheumatoid arthritis patients. Clin Rheumatol 2012; 31: A survey of psychological support provision for people with inflammatory arthritis in secondary care in England. Musculoskeletal Care 2014; 12: Depression in rheumatoid arthritis: A systematic review of the literature with meta-analysis.

Psychosom Med 2002; 64: Anxiety and depression in patients with rheumatoid arthritis. Clin Rheumatol 2007; 26: A blind, randomized, controlled trial of cognitive behavioural intervention for patients with recent onset rheumatoid arthritis: Preventing psychological and physical morbidity. Depression and anxiety with rheumatoid arthritis: BMC Psychiatry 2012; 12: Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis: Clin Rheumatol 2014; 33: Emotions, relationships and sexuality 2013.

Lived experiences of sex life difficulties in men and women with early RA: Musculoskeletal Care 2015; 13: