Debra Westlake, Geoffrey Wong, Steven Markham, Amadea Turk, Jordan Gorenberg, Catherine Pope, Joanne Reeve, Caroline Mitchell, Kerryn Husk, Sabi Redwood, Anthony Meacock, Kamal R. Mahtani, Stephanie Tierney
{"title":"\"她是一块磐石\":英国初级保健中社会处方联系工作者 \"坚持 \"的功能和重要性--现实主义评估的结果","authors":"Debra Westlake, Geoffrey Wong, Steven Markham, Amadea Turk, Jordan Gorenberg, Catherine Pope, Joanne Reeve, Caroline Mitchell, Kerryn Husk, Sabi Redwood, Anthony Meacock, Kamal R. Mahtani, Stephanie Tierney","doi":"10.1155/2024/2479543","DOIUrl":null,"url":null,"abstract":"<div>\n <p>Social prescribing link workers are recently introduced roles in English primary care. One of their intended functions is to support patients with conditions influenced by the wider, social determinants of health. Their main purpose is to connect people to community resources to meet their nonmedical needs. However, our research reveals that link workers provide not only connections but also what we have described as “holding” for individuals with complex needs, who lack informal networks of support or who are waiting to access services. We explore the concept of holding, its meaning and significance in this context, and consider its consequences. As part of a realist evaluation, we observed seven link workers in GP practices in England during focussed ethnographies over a 3-week period. We took field notes and interviewed 61 patients and 93 healthcare and voluntary sector professionals. Nine to twelve months later, we carried out follow-up interviews with forty-one patients, seven link workers, and a link worker manager. We identified four functions of holding: supporting patients waiting for services, sustaining patients as they prepare for change, reducing the emotional burden of primary healthcare professionals, and bearing witness to patients’ distress. Holding appears to be a vital but often overlooked aspect of social prescribing. Patients benefit from having a reliable and consistent person to support their emotional needs. However, similar to the impact of holding on other primary care professionals, there are unintended consequences: some link workers exceed their capacity, become overburdened, experience burnout, and leave their job. Recognizing the importance of holding and understanding its role in link workers’ primary care responsibilities are critical. 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“She’s Been a Rock”: The Function and Importance of “Holding” by Social Prescribing Link Workers in Primary Care in England—Findings from a Realist Evaluation
Social prescribing link workers are recently introduced roles in English primary care. One of their intended functions is to support patients with conditions influenced by the wider, social determinants of health. Their main purpose is to connect people to community resources to meet their nonmedical needs. However, our research reveals that link workers provide not only connections but also what we have described as “holding” for individuals with complex needs, who lack informal networks of support or who are waiting to access services. We explore the concept of holding, its meaning and significance in this context, and consider its consequences. As part of a realist evaluation, we observed seven link workers in GP practices in England during focussed ethnographies over a 3-week period. We took field notes and interviewed 61 patients and 93 healthcare and voluntary sector professionals. Nine to twelve months later, we carried out follow-up interviews with forty-one patients, seven link workers, and a link worker manager. We identified four functions of holding: supporting patients waiting for services, sustaining patients as they prepare for change, reducing the emotional burden of primary healthcare professionals, and bearing witness to patients’ distress. Holding appears to be a vital but often overlooked aspect of social prescribing. Patients benefit from having a reliable and consistent person to support their emotional needs. However, similar to the impact of holding on other primary care professionals, there are unintended consequences: some link workers exceed their capacity, become overburdened, experience burnout, and leave their job. Recognizing the importance of holding and understanding its role in link workers’ primary care responsibilities are critical. If holding work is accepted as a role for link workers, providing training and support to them should be prioritised to ensure successful implementation and positive outcomes for patients, link workers, and primary healthcare staff.
期刊介绍:
Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues