Abstract：
Hospital social workers (HSW) play an important role in health care, providing psychosocial support to families affected by severe illness, and having palliative care needs involving dependent children. However, there are few evidence-based family interventions for HSWs to apply when supporting these families. The Family Talk intervention (FTI), a psychosocial family-based intervention, was therefore evaluated in an effectiveness-implementation study. Within the study, HSWs were educated and trained in the use of FTI in clinical practice. This study examined HSWs\' experiences of barriers and facilitating factors during their initial use of FTI in clinical practice. Altogether, 10 semi-structured focus groups were held with HSWs (n = 38) employed in cancer care and specialized palliative home care for adults, pediatric hospital care, and a children\'s hospice. Data were analyzed using content analysis. HSWs considered FTI to be a suitable psychosocial intervention for families affected by severe illness with dependent children. However, the way in which the care was organized acted either as a barrier or facilitator to the use of FTI, such as the HSWs\' integration in the team and their possibility to organize their own work. The HSWs\' work environment also impacted the use of FTI, where time and support from managers was seen as a significant facilitating factor, but which varied between the healthcare contexts. In conclusion, HSWs believed that FTI was a suitable family intervention for families involving dependent children where one family member had a severe illness. For successful initial implementation, strategies should be multi-functional, targeting the care organization and the work environment.
摘要：
医院社会工作者(HSW)在医疗保健中发挥着重要作用,为受严重疾病影响的家庭提供社会心理支持，以及有涉及受抚养儿童的姑息治疗需求。然而,在支持这些家庭时，很少有基于证据的家庭干预措施可以应用HSWs。家庭谈话干预（FTI）基于家庭的社会心理干预，因此，在有效性实施研究中进行了评估。在研究中，在临床实践中对HSWs进行了FTI使用的教育和培训。这项研究调查了HSWs在临床实践中最初使用FTI期间的障碍和促进因素的经验。总之,10个半结构化的焦点小组在癌症护理和成人专业姑息家庭护理中使用HSWs（n=38），儿科医院护理，和一个儿童收容所。使用内容分析对数据进行分析。HSWs认为FTI是受抚养子女严重疾病影响的家庭的适当心理社会干预措施。然而,护理的组织方式充当FTI使用的障碍或促进者，例如HSW在团队中的整合以及他们组织自己工作的可能性。HSW的工作环境也影响了FTI的使用，时间和管理人员的支持被视为一个重要的促进因素，但是在医疗保健环境之间有所不同。总之,HSW认为，FTI对于涉及一名家庭成员患有严重疾病的受抚养儿童的家庭来说是一种合适的家庭干预措施。对于成功的初步实施，战略应该是多功能的，针对护理组织和工作环境。
