Introduction
The continuous increase of civilizational diseases and the necessity of their complex solution requires the essential education of social workers in the field of civilizational diseases (Belovičová, 2019). Social work should respond to challenges in the field of education, given the main national health problems that are caused by the aging of the population, chronic conditions, emerging and re-emerging deep inequalities in the field of health, which are the result of social injustice. In response to these challenges, social work should broaden its practice to focus specifically on improving client care (Browne, Keefe, Ruth, 2017). Great emphasis is placed on the need for further education in social work in the field of public health, prevention and population health (Ruth, 2015).
At the beginning of the research – the importance of social worker education
At the very beginning of our research, our goal was to find specific information regarding the education of social workers in the issue of civilization diseases, both at home and abroad. We first approached educational institutions, namely the Institute of Further Education of Social Workers and the Association of Social Work Educators. Currently, there is no accredited course in the field of civilization diseases at the Institute for Further Education of Social Workers. However, this institution did not rule out the possibility that this issue will be dealt with in the future, given the global growth of civilizational diseases and the need to educate social workers in this issue, which needs to be addressed. The SP educators' association could not provide us with any relevant information. They do not know institutions from research to education that would deal with this issue. Furthermore, this institution stated that only VŠZaSP sv. Elizabeth. Based on the statement of this association, we found out that on November 15, 2019 in Michalovce, the VI. International scientific conference "Health-social and nursing aspects of civilization diseases", where they dealt with the given issue.
This conference was attended by 200 participants, namely university teachers from VŠZaSP St. Alžbety in Bratislava, LFUK in Bratislava, LFUPJŠ in Košice, SZÚ in Bratislava, Trnava University, Prešov University, Charles University and the Hussite Faculty of Theology in Prague, doctors, nurses, social workers, scientific workers, nutritional therapists, physiotherapists, public health workers. The conference also included lectures by foreign speakers from Poland and Ukraine (Belovičová, Vansáč, 2019). As part of our research, we approached foreign lecturers doc. MUDr. Ivan Mironyuka PhD. from Uzhhorod, who willingly provided us with relevant information on the topic of our research on the issue of civilizational diseases. For a certain period, he worked in the working group of the Ministry of Health of Ukraine for personnel policy in the field of health care, which proposed the introduction of a new specialization in Ukraine, namely social worker in the field of health care. The Ukrainian government has not yet accepted this proposal. In his opinion, this topic is little discussed. He agrees with other experts who say that the participation of social workers in the health care system will continue to grow and expand in the future. The involvement of social workers as members of multidisciplinary rehabilitation teams in medical facilities, the introduction of full-time social worker positions in medical facilities of the narcological, psychiatric, tuberculosis profile is already a daily practice today and will only expand to other specialties and general clinical institutions in the future. Therefore, today it is necessary to change approaches to the training of social workers in the creation of a system of education of social workers related to the specializations of clinical and health social work with practical training in medical facilities. A strong challenge for health care and public health systems is to enrich the study of social workers at universities in the field of civilization diseases. In the Czech Republic, we approached the educational institution MOUSOU, which provides accredited courses for social workers, but just like the Institute for Further Education of Social Workers in Slovakia, they do not have this type of course for social workers in the field of civilization diseases. Next, we approached two civic associations. The first choice was the Association of People Affected by Civilization Diseases of the Slovak Republic, they said that they are currently not interested in educating their employees in the issue of civilization diseases, given that they have a minimum number of employees who have an education in the field of social work and a lack of funding from the state and sponsors. Despite all these circumstances, they consider this form of education necessary. Such education could broaden the horizons of their employees, who could subsequently better educate their clients who suffer from civilization disease. In the Czech Republic, the civic association Civilky told us that they have also not come across the training of social workers in this issue, but they consider such training to be particularly beneficial for clients affected by civilization disease. Our attempts to obtain relevant information were not bypassed by the universities, specifically the FSVaZ UKF in Nitra and the South Bohemian University of České Budějovice - Health and Social Faculty, where they answered that social workers do not directly participate in the prevention of civilizational diseases. We did not even go to the Ministry of Health in the Slovak Republic and the Czech Republic, where there was a consensus that both ministries referred to the Ministry of Labor and Social Affairs and the Family. While compiling the theoretical part of our thesis, we searched for interesting findings. The USA, unlike the Slovak Republic and the Czech Republic, has a Ministry of Health, which goes hand in hand with social services. Their priority goal is to protect the health of all Americans, while placing great emphasis on the education and training of health care social workers to serve the needs of people who suffer from chronic illnesses.
Based on this fact, we can conclude that we are exploring significant reserves in this direction, and we emphasize the need for close cooperation between the Ministry of Health and the Ministry of Labor and Social Affairs and the Family in Slovakia, the Czech Republic, as well as in Ukraine. The Ministry of Labor and Social Affairs and the Family of the Slovak Republic told us that the basic content of departmental education (individual educational programs) resulting from the currently demanding requirements of the Social Work Act is currently clear and will continue to be developed and supplemented for future requirements. They did not meet with the education of social workers in the issue of civilizational diseases and clarified to us the facts that the Accreditation Commission has the competence to discuss and recommend to the Ministry of Internal Affairs and Communications of the Slovak Republic only specialized education, which is anchored in Government Regulation no. 5/2016 Z .z. regulations of the Government of the Slovak Republic implementing some provisions of Act no. 219/2014 Coll. on social work and on the conditions for the performance of certain professional activities in the field of social affairs and the family and on the amendment and supplementation of certain laws. Based on the claims of the Ministry of Internal Affairs and Communications of the Slovak Republic, we approached the Accreditation Commission of the Slovak Republic, but currently no course on the issue of civilizational diseases for social workers is accredited. The Ministry of Internal Affairs and Communications of the CZ informed us that they are not aware that a course related to the issue of civilization diseases has been implemented in the Czech Republic, but at the same time they informed us of the fact that they are currently preparing an analysis of the further education of social workers and workers in social services. Since we did not march on home soil or in our immediate neighbors, we asked the International Federation of Social Workers, IFSW, to provide information for our research. Specifically, we were interested in whether similar research to ours had ever been carried out somewhere. The IFSW commented that they are currently unable to advise us on this issue, emphasized the need for research in this area for the social work profession and wished us well in our research. At the same time, they showed interest in the results of our research.
Aim: Our main goal was to find out how social workers perceive the importance of education in the issue of civilization diseases. At the same time, we found out whether social workers are interested in education in the issue of civilization diseases, and what form of education in the given issue they would be interested in. We also verified the level of their current knowledge in the field of civilization diseases.
Methodology: We were helped to carry out the research by experts and full members of the Slovak Chamber of SP and ASP, who expressed their opinions using questionnaires. The chamber was established on the basis of Act no. 219/2014 Coll. on social work and on the conditions for the performance of certain professional activities in the field of social affairs and the family, and on the amendment of certain laws, from which its tasks also follow. Members of the chamber are natural persons who are professionally qualified to perform social work, perform social work, and are duly registered in the list of members of the chamber through a written application, based on Act no. 219/2014 Coll. paragraph 2 letter a) and b). The opinions of these experts were important for us, considering the fact that the Slovak Chamber of Health and Welfare already took steps in the past to solve the issue of the performance of social work in the health sector and the occupational classification of health workers in the department of the Ministry of Health of the Slovak Republic. In 2017, she organized a meeting of experts from various professions and academic staff. The goal of this meeting was to create legislative documents for the purpose of solving this issue. The file consisted of 111 respondents, of which 42 were social work assistants and 69 were social workers. The first step of our research was to submit an application to the Slovak Chamber of Social Workers and Social Work Assistants for permission to conduct research. This organization gave us written consent to conduct the research. Based on written consent, we put the questionnaire into electronic form and sent an internet link to the Slovak Chamber of SP and ASP. Based on our request, the chamber published our questionnaire on the official website of the Slovak Chamber of SP and ASP, with which it addressed all its members to participate in our research.
Demographic characteristics: The group consisted of 93 (83.78%) women and 18 (16.22%) men. The higher proportion of the female gender reveals their higher interest in education in the issue of civilizational diseases, compared to the male gender. The age category ranged from 20 to 61 and over. Most respondents who participated in the research were in the age category of 31-40 years, more precisely 39 (35.14%). Based on the highest level of education, we found that 42 (37.84%) social work assistants, 62 (55.86%) social workers, and 7 (6.31%) social workers had a higher education III. degree. Another demographic data was the work field of our respondents. The highest proportion of respondents, exactly 52 (46.82%) respondents work in social services, the remaining respondents work in areas such as healthcare, public administration, the private sector and other areas. We were also interested in another and at the same time the last demographic data, with which we found out the exact classification of respondents in employment. In addition to 10 (9.01%) social work assistants and 52 (46.85%) social workers, 21 (18.92%) administrative workers were found in the research. The rest consisted of field workers, social rehabilitation instructors, social work officers, volunteers, a supervisor, a social work coordinator, a teacher, a teacher, a nanny, a specialist in a community center, an assistant director, and one currently unemployed.
Results
Question no. 1: Do you agree with the statement that the education of social workers in the issue of civilization diseases is important? From the answers of 111 respondents, we can clearly state the fact that 97 (87.39%) of social workers consider education in the issue of civilizational diseases to be important. Chart no. records these answers. 1.
Graph no. 1: The importance of education in the issue of civilization diseases.
Source: own processing
Question no. 2: How would you rate your knowledge in the area of civilization diseases? The purpose of this question was to set a mirror of self-reflection for our respondents, who could use it to evaluate their knowledge in the field of civilization diseases. Out of the total number of 111 respondents, 66 (59.46%) marked their level of knowledge as average. This figure shows graph no. 2.
Graph no. 2: Percentage of respondents' knowledge of the issue of civilizational diseases.
Source: own processing
Question no. 3: Do you have information about the further education of social workers in the issue of civilizational diseases? Based on this question, we found out what information our respondents have about further education in the field of civilization diseases. 104 (93.69%) have no information. Graph No. 3 shows the results.
Graph no. 3: Respondents' information on further education of social workers in the issue of civilizational diseases.
Source: own processing
Question no. 4: Would you be interested in education in the issue of civilization diseases? The majority of answers were positive, that is, out of 111 respondents, the majority of 96 (86.49%) respondents are interested in education in the field of civilization diseases. We made a graph from the respondents' answers. 4.
Graph no. 4: Interest in education in the field of civilization diseases.
Source: own processing
Question no. 5: What form of education in the issue of civilization diseases would you be interested in? From the answers of the respondents, we can clearly confirm that lectures and seminars are of the highest interest, exactly 71 (63, 96%) respondents. 5 (4.50%) respondents are not at all interested in education on the issue of civilization diseases. Graph no. points to these facts. 5.
Graph No. 5: What form of education in the issue of civilization diseases would you be interested in.
Source: own processing
Question no. 6: Do you think that you will use the acquired knowledge from the completed educational activity on the issue of civilization diseases in practice? 98 (88.29%) respondents think that knowledge from this education will be used in practice and 13 (11.71%) would not use this knowledge in practice. On this basis, we can conclude that a large part of the respondents can effectively use the acquired knowledge from this type of education in practice. You can find all the answers in graph no. 6.
Graph no. 6: Use of knowledge from education in the issue of civilizational diseases in practice.
Source: own processing
Question no. 7: What area of your life would the knowledge gained from education in the field of civilization diseases have an impact? In this question, we offered the respondents several options to choose from. 82 (73.87%) respondents think that the acquired knowledge from education in the issue of civilization diseases has an effect primarily on more effective work with a client suffering from civilization disease. The results shown in graph no. 7.
Graph no. 7: The influence of acquired knowledge from education on the issue of civilizational diseases.
Source: own processing
Question no. 8: Do you think that clients suffering from civilization diseases would be interested in services in terms of providing information and possible prevention of their disease through a social worker specialized in the issue of civilization diseases? 75 (67.57%) respondents think that clients should be interested in services in the provision of information and possible prevention of their illness through a social worker specialized in the issue of civilization diseases. You can find the results in graph no. 8.
Chart No. 8: The opinion of social workers on the interest of clients suffering from civilization diseases, for services in the framework of providing information and possible prevention of their disease through a social worker specialized in the issue of civilization diseases.
Source: own processing
Question no. 9: Do you think that a social worker who has sufficient knowledge in the issue of civilizational diseases has a job application on the labor market? With the help of this question, we found that 51 (45.95%) respondents see the application of a social worker who has sufficient knowledge in the field of civilizational diseases in the labor market. All data on question no. 9 we have shown in graph no. 9.
Chart No. 9: Knowledge of a social worker in the issue of civilizational diseases and their impact on their employment in the labor market.
Source: own processing
Question no. 10: In your opinion, what benefits does the education of social workers have in the area of civilization diseases? We intentionally left the last question open, so that the respondents could openly express their opinion, what benefits they see in the education of social workers in the above-mentioned issue. The number of responses and their percentage is shown in table no. 1.
Table no. 1: Benefits of education in the issue of civilization diseases, respondents' answers.
Source: own processing
Several respondents agreed in the answers that they consider the benefits of this education to be: personal development, general overview, better quality work and more adequate help to clients, higher level of empathy, understanding of the situation of a client who suffers from some type of civilization disease, higher level of counseling, increased qualifications, better education of the client in the field of nutrition and prevention, guiding clients to a healthy lifestyle, more effective comprehensive care of the client/patient in cooperation with other experts. We have selected the 5 most interesting answers from respondents/social workers and social work assistants: Respondent no. 1: "Education is the duty of every social worker who is a member of the chamber, this follows directly from Article 4, paragraph 7, letter e) of the Statute of the Slovak Chamber of SP and ASP. Social work is a multidisciplinary science and its contribution can be visibly grasped in every social problem. In the life of an individual and a group, education in the issue of civilization diseases is also necessary." Respondent no. 2: "Social work is a multidisciplinary science, it has the perspective of being applicable in various sectors and branches. This also requires multispectral education, because clients coming to a social worker often have multi-problems. It is useful to have at least a basic knowledge in the field of civilization diseases." Respondent no. 3: "No education of a social worker is useless. He will certainly encounter various problems, from various fields, during his practice. Nowadays, many people suffer from some kind of civilization disease, so it is important for social workers to be educated in this as well." Respondent no. 4: "A social worker in daily contact with recipients of social services could provide knowledge, advice, guidance to clients in managing their lives, the need to visit a doctor, solutions for applying themselves in everyday life with the presence of certain diseases." Respondent no. 5: "A social worker knows how to react adequately if he learns about the illness that the client has and takes it into account in the forms of help he offers him. He knows how to navigate the prescribed medications that the client has or what limitations the illness brings, e.g. when looking for a job, when raising children, caring for a relative, etc. During their studies, social workers did not have subjects about diseases of individual systems (digestive, cardio-pulmonary, etc.) and about the most common diseases as they occur, nor about the prospects for the development of these diseases in the client, so they cannot take this into account in the counseling."
Discussion
With our research, we primarily tried to find out what importance social workers attach to education in the field of civilizational diseases, and at what level their current knowledge in this sphere is. On the basis of all the results mentioned above, we can conclude that the education of social workers in the issue of civilizational diseases has significance and perspective in the future. Social workers are interested in education in the issue of civilization diseases, and they have chosen lectures and seminars as the preferred form of education. By educating social workers in the issue of civilization diseases, we increase the rate of assistance to chronically ill individuals. We help them feel less isolated and give them hope that social work as a profession is doing everything to improve their quality of life. Social workers rated their knowledge as average, and at the same time highlighted the need for further education in this issue. They are thus primarily based on practical experience working with their clients. Clients who come to a social worker often have social, health, economic and many other problems, which requires the multispectral education of social workers. They should have at least basic knowledge in the field of civilization diseases, which they could subsequently develop with the help of further specialized education. Social workers prepared in this way can be realistically and successfully confronted with the demands of professional performance in social services and healthcare.
Research Limitations
During the compilation of our research, during the collection of data and the search for sources for our research, we came to the conclusion that similar research has not yet been carried out in Slovakia. Therefore, it is important and necessary to take into account the limits of our research based on the results obtained from the answers of our respondents. The first limitation of our research is the finding that there is currently no form of education in the issue of civilizational diseases for SP and ASP that would be accredited. We are aware that this issue is not sufficiently researched in our country and we see significant reserves in it. Another limitation of the research is the number of respondents participating in the research. It is important to take into account that only part of the members of the Slovak Chamber of SP and ASP participated in our research, exactly 111 members, which represents approximately one tenth of all regular members of this chamber. The research set is therefore insufficient for scientific research goals. Therefore, it is necessary to continue developing this research through another specialized study and the subsequent investigation of the interest of other SPs and ASPs in education in the issue of civilizational diseases.
Recommendations
We recommend involving universities in which the study of social work takes place in the system of further education of social workers in the issue of civilizational diseases. Their task will be:
- Streamline the system of further education of social workers in the issue of civilizational diseases.
- Adapt the study program of social work in the issue of civilization diseases to real conditions in practice.
- To enable students to choose a narrower specialization in the issue of civilizational diseases.
- Streamline the system of training social work students in the form of internships in medical facilities.
- To motivate students' interest in education in the issue of civilizational diseases with the help of new education reforms.
- Obtain a certificate of accreditation for the education of social workers in the field of civilizational diseases.
We recommend social workers and social work assistants:
- Realize the need for continuous education in the issue of civilizational diseases.
- To participate in education in this issue.
- To work closely with other experts of the multidisciplinary team in medical facilities.
For healthcare facilities, we recommend:
- Include social workers as full members in their multidisciplinary teams.
- Introduce full-time job positions for social workers.
- Create prerequisites for social workers for their financial evaluation.
We recommend for the state:
- Greater linking of cooperation between the Ministry of Health and the Ministry of Labor and Social Affairs and Family, following the US model.
- Inclusion of the specialization of social worker in health facilities, addition and definition of their duties in Act no. 219/2014 Coll. on social work and on the conditions for the performance of certain professional activities in the field of social affairs and the family and on the amendment and supplementation of certain laws.
- Financially support the education of social workers in the issue of civilization diseases.
Conclusion
Civilization diseases represent a serious social, medical, social and economic problem of the 21st century. Their dramatic rise requires innovations in the field of social services with the help of the rise of the educational level in the issue of civilizational diseases. Social workers can do a great job and help their clients suffering from some type of civilization diseases, in applying recommendations about health care and possible prevention, at the same time guiding their clients in leading a proper lifestyle. With the help of our research, we managed to prove that this form of education is beneficial, significant and necessary for the vast majority of members of the chamber. The implementation of the education of social workers in the issue of civilizational diseases requires the participation of experienced experts from practice, linking cooperation between departments, the Ministry of Labor, Social Affairs and the Family and the Ministry of Health in the Slovak Republic. In this process, the University of Health and Social Services of St. Alžbety in Bratislava, the Institute of Further Education of Social Workers, as well as the Slovak Chamber of Social Workers and ASP and many other institutions and organizations that are not indifferent to this issue. Given that social workers are leaders in the field of interprofessional collaboration, we believe that social work in healthcare will have a greater voice and a place at the table in the future.
Authors: Mgr. Miroslava Weiss doc. MUDr. Mária Belovičová, PhD.
List of references
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