Research On Social Work Intervention In Ability Of Chronic Self-Management Of The Elders With Chronic Diseases At Home

Home-based care is an important way of elders care in our country.More than 90%of the elderly are cared for at home.Of the elderly,72.76%have more than one chronic disease.It means the services of elderly people with chronic diseases will become an important part of home-based care services.With the deepening of social work participation in home care services,social Work have to face the problem of chronic self-management of elderly people with chronic diseases who are cared at home.Whether this problem can be solved successfully will not only affect the development of home-based care services,but also affect the in-depth service of social work professionals.In response to this problem,Most of the current researches focus on the self-efficacy of elderly individuals with chronic diseases who are cared at home,Ignoring the role of family.In particular,there is a lack of exploration of how social workers can help families with chronic illnesses to improve their self-management skills through family support.The study conducts research on the process of social workers helping the elderly with chronic diseases to improve their self-management capability in the home environment.The study also try to finding strategies of social workers to help the elders with chronic diseases to improve their self-management skills with family support.By exploring these,This study hopes to achieve the goal of helping social workers with knowing how to address the problem of self-management capabilities of elderly people with chronic more effectively.This study conducts research on home-based care for the aged of H city x Social Work Service Agency,following up on the service of 3 social workers when they help chronic illness elders improve their capabilities of chronic disease self-management.The study takes the theory of social support as the theoretical framework of the study and uses case studies to conduct research,using literature method,participant observation,depth interviews and other data collection methods.This research finds that:(1)Social workers need to use family support to help the elderly with chronic disease improve their self-management ability.When assessing service needs,it is necessary to use family help to understand the need for self-management of elderly people with chronic diseases.When the service is carried out,it needs the participation of family members to meet the self-management requirements of the elderly with chronic diseases and create a favorable family environment,Especially for providing guidance on diet,medication and exercise etc.(2)The effective family support strategies employed by social workers in helping the elderly with chronic diseases to improve self-management include:Selecting major family supporters within the family support system to intervene,concerned about the physical health and psychological conditions of major family supporters,recognizing the positive experience of family members in assisting the elderly with chronic diseases to self-management,give family members health education guidance on self management of chronic diseases,consider family support pressure when using family support,enhance the communication of chronic diseases in elderly people with chronic diseases at home and their families.(3)The difficulties and challenges faced by social workers in helping the elderly with chronic diseases to improve their self-management skills mainly include:Family members have weak awareness of assisting the elderly with chronic diseases to self-manage.There is a tense family relationship between the family and the elderly with chronic diseases.Social workers and their families have difficulties in maintaining long-term stable contact.The conflict between the professional experience of social workers and the personal experience of family members.Difficulty in finding a service intervention point for the whole family of chronically ill people.(4)There are two main reasons for social workers to use family support to help the elderly with chronic diseases to improve their self-management skills:First,because chronic diseases are characterized by long-term,repetitive nature,and high complications,elderly people with chronic diseases at home need family support to improve their self-management skills.Second,the service logic of social work determines that the elderly with chronic diseases need to rely on the support of the family when they improve their self-management skills.From a service perspective,social work considers that the self-management of elderly people with chronic diseases in the home is carried out in the daily interactions between the elderly with chronic diseases with the family;In terms of service strategies,social work indirectly helps elderly people with chronic diseases to improve their self-management skills by intervening in the family support system for the elderly with chronic diseases.The services of social work are different from the services of public health and nursing.Public health and nursing pay more attention to the elderly themselves.Therefore,social work just makes up for the lack of public health and nursing.This study suggests that social workers should fully utilize family support when developing services for the elderly with chronic diseases in the home.For example,selecting the main family supporters in the family support system to intervene and excavating the positive experience of family supporters in assisting the elderly with chronic disease to manage themselves.By doing that,social worker play a supporting role in family self-management of chronic diseases such as dietary management,medication management,disease surveillance,complication prevention,and emotional support for the elderly with chronic diseases at home.And helping elderly people with chronic diseases at home improve their self-management skills.The findings of this study are conducive to the use of family support by social workers in assisting elderly people with chronic diseases to improve their self-management skills.It is also beneficial to identify the professional orientation of social workers in home-based care services and improve the professionalism of social work services.In the meantime,due to the limitation of the researchers' ability and the timing,there still remains some aspects that need to improve.For example,the theoretical research perspective is not deep enough.In particular,further thoughts need to be carefully considered in the guidance of theoretical research on this study.Due to limitations in research time and effort,the selection of research cases and research subjects is not sufficient.That make the objectivity of the conclusions of the study are affected.In the analysis and discussion of the study,due to the insufficiency of individual ability,it is very difficult to analyze the reasons and refine the service basis.In the meantime,due to the limitation of the researchers' ability and the timing,there still remains some aspects that need to improve.For example,the theoretical research perspective is not deep enough.In particular,further thoughts need to be I carefully considered in the guidance of theoretical research on this study.Due to limitations in research time and effort,the selection of research cases and research subjects is not sufficient.That make the objectivity of the conclusions of the study are affected.In the analysis and discussion of the study,due to the insufficiency of individual ability,it is very difficult to analyze the reasons and refine the service basis.This paper is divided into seven chapters:Chapter 1 Introduction introduces the background,significance and questions of this study.The first question is when social workers help older people with chronic diseases to improve their self-management skills,do they need to use family support?If need to use,how to use?The second question is What is the basis for social workers to use family support to help the elderly with chronic diseases to improve their self-management skills?how is it different from public health and nursing?Chapter 2 Literature Review mainly review related research of chronic disease self management,chronic disease self management of the elers,home-based care of the elders with chronic disease,the intervention of social work service in chronic diseases management of the elders with chronic disease and social work service from the perspective of social support theory.Chapter 3 Research Design introduce the theoretical perspectives and the method of this research.The study takes the theory of social support as the theoretical framework of the study and uses case studies to conduct research,using literature method,participant observation,depth interviews and other data collection methods.Chapter 4 Research Findings Discussions analyze the intervention process and service reasons for social workers to help the elderly with chronic diseases to improve their self-management skills.Chapter 5 Research Conclusion includes the summary of this research,the proposal and the limitations of it.The chapter summarize the main findings of this study briefly.It is suggested that social workers use their family support to provide services for elderly people with chronic diseases at home.At the same time,this chapter also introduces the limitations in this research.