Psychosocial Dimensions of Medical Social Work Practice: Roles, Job Satisfaction and Organisational Role Stress

Abstract

Medical social workers play a crucial role in addressing the psychosocial dimensions of healthcare, yet their practice realities remain underexplored in the Indian context. This study explores the various roles, functions, job satisfaction, and organizational role stress of medical social workers using the qualitative case study method. Participants from government hospitals, private hospitals, and palliative care NGOs were selected from Thiruvananthapuram district in Kerala. Semi-structured in-depth interviews were used for data collection, and the data were analysed using thematic analysis. The findings revealed that a wide range of psychosocial functions were performed by the participants, their nature varying across settings. The palliative care setting offered the greatest role clarity and autonomy, while private and government hospitals constrained their practice through institutional priorities and resource limitations. All participants reported higher levels of compassion satisfaction, which served as a protective factor against occupational adversity. Extrinsic dissatisfiers identified were lower remuneration, limited career development opportunities, and absence of professional supervision. Major organizational role stressors like role overload, role ambiguity, role erosion, and role inadequacy were identified, all of which created a psychosocial care paradox, where the medical social workers responsible for patient wellbeing operated within conditions that affected their well-being. This study, thus, calls for equitable career opportunities and professional status for medical social workers and the organizational adoption of a biopsychosocial model of healthcare, where psychosocial care receives equal importance as biomedical care.