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P-141 How do palliative care social workers apply and model the concept of ‘safe uncertainty’?
  1. Rebecca Salama,
  2. Sarah Dowd,
  3. Sophie Hanley and
  4. Lorraine Carter
  1. Princess Alice Hospice, Esher, UK


Background Research suggests that the poor management of uncertainty in palliative care can significantly impact patient outcomes (Ellis-Smith, Tunnard, Dawkins, et al. BMC Palliat Care. 2021; 20:168), as well as the experience of bereaved families (Robinson, Pilbeam, Goodwin, et al. BMC Palliat Care. 2021; 20(60)). Interestingly, it has also been argued that the ability to tolerate and work with uncertainty is a defining feature of the social work role (Fook. Social work: a critical approach to practice. 3rd ed., 2016). In some therapeutic and social work settings, the concept of ‘safe uncertainty’ is used as a simple framework for better supporting service users and their families (Mason. Human Systems. 1993; 4(3–4): 189–200).

Aims To review the literature around ‘uncertainty’ in palliative care social work. To understand the perspectives of palliative care social workers, drawing on their experiences of dealing with uncertainty. Do they confidently hold positions of ‘safe uncertainty’ with patients and families? What are the benefits of doing so? Why is the pull of ‘safe certainty’ so strong and how can we overcome this as professionals?

Methods A mixed methods approach consisting of a literature review followed by a focus group (n=8) will be used to explore the shared views and experiences of palliative care social workers (May – June 2023). A reflexive thematic analysis (Braun, Victoria. Thematic analysis: a practical guide. 2021) will then be used to identify themes and patterns (July 2023).

Results The results of the literature review will be used to develop a set of focus group questions. Following the analysis stage, initial results will be shared with the participants so they can comment on their descriptive validity and reliability. Any feedback will be incorporated into the final write-up.

Conclusion It is hoped that the findings will help palliative care social workers to define their unique contribution to end-of-life care more accurately, to not only support their own sense of value and identity, but to help them share it with other members of the multidisciplinary team.

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