“Integrated Medical and Nursing Care” Service Practice: The Adaptive Roles of Social Workers in Elderly Care Institutions and Implications for Age-Friendly Modifications
DOI:
https://doi.org/10.71204/xspx6a71Keywords:
Age-Friendly Modifications, Integrated Medical and Nursing Care, Social Worker, Adaptive RoleAbstract
This study examines elderly care institutions to investigate how the scope and quality of age-friendly environmental modifications continuously shape the effectiveness of integrated medical and nursing care services, and analyzes the adaptive responses and practices of social workers within this process. Based on qualitative research, the findings reveal that inadequacies in the built environment directly trigger service disruptions and potential risks, forming a “hidden bottleneck” that restricts service quality. Social workers exhibit significant agency by proactively adopting assessment, advocacy, and coordination strategies. Nevertheless, their effectiveness is constrained by structural factors including resource shortages and institutional limitations. This study advocates for a synergistic “Environment–Service–Person” framework and highlights age-friendly environmental modification as a core determinant of service quality. Such a perspective is critical to promoting the operationalization of integrated medical and nursing care and improving overall service quality.
References
Cashwell, S. (2024). Bringing environmental justice to the practice setting: Putting the environment in person-in-environment. Journal of Human Rights and Social Work, 10, 365–372.
Chaudhury, H., Mahmood, A., & Valente, M. (2017). The influence of physical environment on the quality of life of residents in long-term care settings: A systematic review. The Gerontologist, 57(4), 775–790.
Chen, Z., & Lin, Y. (2025). Preparatory palliative care in private nursing home and the embedding path of social work. Journal of Nanjing Medical University (Social Sciences), 25(4), 344–346.
Greene, R., Greene, N., & Corley, C. (Eds.). (2023). Resilience enhancement in social work practice: Anti-oppressive social work skills and techniques. Springer.
Huang, C., Nie, X., & Li, Y. (2025). Evolution and practical exploration of China's integrated medical and nursing care policy. Chinese Journal of Health Education, 41(10),953-958.
Lawton, M. P., & Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer & M. P. Lawton (Eds.), The psychology of adult development and aging (pp.619–674). American Psychological Association.
National Association of Social Workers. (2003). NASW standards for social work services in long-term care facilities. NASW Press.
National Health Commission of the People's Republic of China. (2025). Work plan for demonstration projects of medical and nursing integration (2025 ed., Document No. G.W.L.L.F. [2025] No. 8).
Pockett, R., & Pezzullo, L. (2020). Social work in aged care: An international perspective. International Social Work, 63(5), 601–614.
State Council General Office. (2015). Guiding opinions of the General Office of the State Council on forwarding the notifications of the National Health and Family Planning Commission and other departments on promoting the integration of medical and health care with elderly care services (Document No. 84 [2015] of the State Council General Office).
Wahl, H. W., & Oswald, F. (2010). Environmental perspectives on ageing. In D. Dannefer & C. Phillipson (Eds.), The Sage handbook of social gerontology (pp.111–124). Sage.
Wang, C., Pan, Y., Li, X., & Qiang, S. (2025). A mixed-methods investigation for effects of built environments on older people's social interaction in care homes. Frontiers in Public Health, 13, 1693935.
Yin, M., & Liu, Q. (2026). Research on the generation mechanism of practical knowledge in social work. Journal of Social Work and Management, 26(1), 11–20, 41.
Zhang, W. (2017). Social workers' "reflective professionalism" and core professional competence: Interpretation and reflection on "reflective social work theory." Journal of China Agricultural University (Social Sciences Edition), 2017(3),25-36.
Zhou, Y. (2019). Design and interpretation of elderly care facility (Vols. 1–2). Architecture, (10), 53.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Guoliang Xu, Xingqi Tian (Author)

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles published in this journal are licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are properly credited. Authors retain copyright of their work, and readers are free to copy, share, adapt, and build upon the material for any purpose, including commercial use, as long as appropriate attribution is given.
