How social workers are positioned and constructed as contributors within national palliative care policies in Sweden: a policy analysis

Abstract

Background: Palliative care is expected to acknowledge physical, psychological, emotional, spiritual, and social needs, to which social workers can contribute with expertise on recognizing the importance of social relations and how social inequalities impact on individuals. The social work profession faces challenges in claiming their contributions in the hierarchies of medical professions. Polices play an important role in constructing and positioning responsibilities of professions. Objectives: To analyze how social workers are positioned as contributors to palliative care within national-level policies in Sweden. Methods and materials: A policy analysis was conducted through a constructivist lens. Data were collected from 10 Swedish national-level policy documents on palliative care. Results: Three themes emerged: “A natural presence conveying special expertise”; “Emotional conversational support before and after death”; and “Practical support.” Overall, social workers’ contribution was vaguely described and in similar ways as registered nurses. Conclusion: In Swedish policies analyzed, social workers’ contributions were difficult to differentiate from that of registered nurses, which may complicate their mutual collaborations and cause confusion for individuals at the end of life and their next of kin. Future research on how different professions are positioned within palliative care is needed to reduce risks of role blurring between professions with similar aims. Moreover, given social workers long history of psychosocial knowledge, meanings of this concept need to be further acknowledged.