J. Sky Niesen

Date of Dissertation


Document Type

Banded Dissertation

Degree Name

Doctor of Social Work (DSW)


Social Work

First Advisor

Robin R. Whitebird, PhD


Social Work


Social work has a long standing relationship with healthcare. Beginning in the settlement house movement, social workers have provided a dynamic micro, mezzo, and macro role in medical settings. Social work’s ecological systems perspective allows for the inclusion of environmental and social justice factors in healthcare delivery. Ecological theory, epistemologically rooted in social work, is used as a conceptual framework throughout the three products, as the contextual environment is viewed as integral in understanding cancer patient experiences.

The first product of this Banded Dissertation is a conceptual article detailing the need for culturally responsive practice methods in oncology care with rural Indigenous people. Oncology systems have increasingly invested in psychosocial care, yet disparities exist in psychosocial oncology care in the context of diverse rural settings. Social workers must become leaders in the healthcare arena in order to advocate and provide essential psychosocial, culturally responsive services to marginalized and underserved people.

The second product includes qualitative research methodology with participants who are rural cancer patients in Illinois. The purpose of the second product was to explore psychosocial experiences of cancer patients who reside in a rural community in Illinois. The study used a rural cancer wellness center, Home of Hope, to recruit and interview 18 participants. The interviews were transcribed and organized into recurrent themes, highlighting the unique psychosocial experiences of the rural context.

The third product is a commentary calling for an increased presence of the social work profession in the precision medicine movement. Precision medicine is essentially sequencing an individual’s genome in order to develop targeted medical interventions. The professional of social work, the article argues, has work to do in terms of becoming integrated with associated practice and ethics of this movement. This commentary was published in the journal Social Work in May 2016.

This dissertation focuses on the intersectional nature of social work’s interface in specialty healthcare – particularly in rural and diverse contexts. The products are connected by the common thread of viewing the healthcare patient as “whole.” Ecological theory, epistemologically rooted in social work practice, values, and ethics, is used as a conceptual framework throughout the three products. The contextual rural environment is integral in understanding patient experiences in order to address healthcare disparities.

Included in

Social Work Commons