Authors (including presenting author) :
Shek SS(1), Tong HL(2)
Affiliation :
(1)Medical Social Services Department, Yan Chai Hospital (2)Medical Social Work Department, Caritas Medical Centre
Introduction :
In face of suboptimal provision of prehabilitation training and perioperative discharge planning for Orthopedic and Surgical patients resulting in long length of stay after surgery, the KWC ERAS service was commenced since October 2020. The service is implemented in a multi-disciplinary approach with doctors, nurses, medical social workers (MSW), physiotherapists and occupational therapists etc which starts at out-patient setting before operation to enhance patient optimisation, prehabilitation, perioperative discharge planning and early arrangement of community services.
Objectives :
(1) to assess patients’ social demographics, problems encountered and service needs (2) to evaluate the roles of MSW in ERAS in KWC
Methodology :
A retrospective study of 1948 cases from ERAS program of PMH, YCH and CMC was conducted from 1.10.2020 to 31.10.2022. These cases were studied for their psychosocial background, problems encountered for the operation and social resources mobilized. Further analysis was conducted for the younger (≤65 years old) cancer patients to examine their characteristics, associated problems and interventions of MSW.
Result & Outcome :
Totally 1948 cases with 55% male and 45% female, aged from 17 to 93 with an average age of 68 from PMH, YCH and CMC were studied of. 65% of total patients was for cancer related surgeries and 35% for orthopedic surgeries. Almost all patients showed various worries related to the illness and surgeries, while 67% of total patients encountered problems related to caring or living environment. With MSW’s intervention, patients were psychologically prepared
for receiving surgeries, and discharge plan was formulated before surgeries with arrangement of home support services or old age home for instance, respite placement. On the other hand, 40% of cancer patients were of younger age from 17-65. They experienced much more anxious and depressive symptoms, poorer acceptance and adjustment towards illness, as well as more financial concerns than their elder counterparts. Therefore, MSW had rendered in-depth counselling on emotion, applied financial resources and arranged community social services. Apart from timely discharge planning for elder patients with discharge and care problems, this study suggests that MSW could pay an important role in providing psychosocial support to patients, particularly putting more attention to emotional needs of younger cancer patients in the ERAS program in future.
