The Role of “Medical Social Worker” in Cardiovascular Thoracic Surgery

Cardiovascular system is relating to the circulatory system of human body, which comprises the heart and blood vessels and carries nutrients and oxygen to the tissues of the body and removes carbon dioxide and other wastes from them. It plays an important role in helping the human body to meet the demands of activity, exercise, including maintains body temperature and stress. Captivatingly, by reason of some dysfunctional in body function lead to cardiovascular disease that especially involve narrowed or blocked blood vessels that can make cause to a heart attack, chest pain or stroke too. And Cardiothoracic Vascular surgery is related with surgery of thorax which entails with great complications somehow. Work carried out by trained personnel with the aim of alleviating the conditions of those people in a community suffering from any disease that personnel factually Social worker particularly who engage in medical practice. Supplementary, Medical Social Worker can perform their appreciable role in pre-operative stage, at operative stage, post-operative stage, at managing post-operative outcomes and notwithstanding retraction in pre-position of thoracic surgery of patient who unusually effected from cardiovascular disease. In this paper attempt has been made to analyses role of Social Worker in thoracic surgery. The present paper has been portrayed in two parts, parts one related with general description and part II related with specialized approach.


INTRODUCTION
The cardiovascular system speaks about the heart, blood vessels and the blood. In it, blood contains oxygen and other beneficiary nutrients which Human body needs to survive or healthy functioning of. However, literally meaning of it may be fabricated as "cardio" or heart and "vascular" or a system or network of blood vessels. In this process these essential nutrients which have vital role to make human body healthy secrete from the blood and whatever needed transferred to body or some parts of it at one fell swoop to survival of body human organs while it functioning or fight with any disease also throw somehow waste products like carbon dioxide (The red blood cells then pick up the carbon dioxide and transport it back to the lung) reverse into the blood, for the purpose of removing it from body. The primarily main function of the cardiovascular system is generally acknowledged to maintain blood flow to all parts of the body, and make it to survive in effectively. In this process, the function of Veins is primarily associated with to deliver used blood from the body provide backing to the heart. Blood in the veins is low in oxygen and high in carbon dioxide. All the veins drain these components into the superior and inferior vena cava of the heart which then exhaust into the right atrium of the heart. Consequently, the right atrium pumps blood into the right ventricle. Then the right ventricle pumps blood to the pulmonary trunk, through the pulmonary arteries and into the lungs. In the lungs the blood picks up oxygen that human do away with breathe in and gets do away with carbon dioxide, which breathes out by human being. From the lungs, blood drains into the left atrium and is afterward pumped into the left ventricle. The left ventricle followed by pumps this oxygen-rich blood out into the aorta which after that distributes it to the rest of the body through other arteries. Thus, cardiovascular system is the circulatory, system which consists of the heart, which is a muscular pumping device, and a closed system of vessels called arteries, veins, and capillaries. Which primarily engage in transportation system of nutrients and other essentials material to maintain energy which ultimately supports human life to survive and maintain effectiveness of Cell, Tissue and other organs of body parts healthy, and at the same time removed the wastage of the body part to control harmful infection. So, number of control mechanisms help to regulate and integrate the miscellaneous functions and component parts of the cardiovascular system one at a time to supply blood to specific body areas need basis. Rundown, saying this it ensures a constant internal environment surrounding each body cell not considering of differing demands for nutrients or production of waste products.
Cardiothoracic primarily related with the heart and chest or lungs. It is the field of medicine involved in surgical treatment of organs inside the thorax (the chest) generally treatment of conditions of the heart (heart disease) and lungs (lung disease). As a disease of cardiovascular system technically known as Coronary thrombosis where the formation of a blood clot takes inside a blood vessel of the heart. Congenital heart disease is a general term for a range of birth defects that affect the normal workings of the heart or proper functioning.

Social Work
Social work is associated with practice-based profession along with an academic discipline that fit into place in promotion of social change and development, social cohesion, and the empowerment and liberation of people. Social work centrally connected with enhancement of principles of social justice, human rights, collective responsibility and respect for diversities of the system in ever dimension such as Social, Economical and Political.
As per, Canadian Association of Social Workers, "Social work is a profession concerned with helping individuals, families, groups and communities to enhance their individual and collective well-being. It aims to help people develop their skills and their ability to use their resources and those of the community to resolve problems. Social work is concerned with individual and personal problems but also with broader social issues such as poverty, unemployment, and domestic violence." Thus, securing of Social Development with the mode of equality, liberty and basic provision to needy as theme of equity is the primary concern of Social Work.

Social Worker
Social workers those who work for welfare of Individual, Family and Community and they usually work in different area. However, different type of Social Workers may be identified as:

Medical Social Worker
Medical social workers are generally specialized their specialization can be in different affairs such as public health, geriatric, palliative, and inpatient medical or mental health care. Further they can put forward in perform in different area of public health more than ever in hospitals or other specialized medical settings like nursing homes, rehabilitative care centers, or related home-care services too.

Objective of the Study
To analyses the role of Social Worker at different stage in Cardiothoracic Vascular surgery

RESEARCH METHODOLOGY
The study has been conducted on the basis of both secondary as well as primary data. For the purpose of primary data about twenty different social workers has been interacted in intent with derived inferences as a respondent for supporting the study. Further, territory method has been also applied for culled out secondary data. Apart from this, data tabulated in a percentage form for better explanation of result and also supported by graph and chart to better understanding.
Cardiothoracic Vascular surgery is the field of medicine involved in surgical treatment surgical treatment of organs inside the thorax generally treatment of conditions of the heart and Lungs disease. As per path of thoracic surgery there is need to understand vascular disease and its common treatment along with new development as provided in Table  1.

Difference between cardiac and thoracic Surgery
Cardiac surgery involving the heart including great vessels but general thoracic surgery first and foremost relating to the lungs, esophagus, and thymus, etc. is usually done by separate

Lung volume reduction surgery
Parts of the lung that are particularly damaged by emphysema are removed, allowing the remaining, relatively good lung to expand and work more efficiently.

Lung cancer surgery
In this case, not all lung cancers are suitable for surgery. The stage, location and cell type are important limiting factors.

Lobectomy
In this surgery generally removal of a lobe of the lung is taken place for treatment of disease.

Sublobar resection
In this approach of surgery predominantly medicinal removal of part of lobe of the lung is initiated by practitioner as per the requirements of medicinal of disease.

Segmentectomy
Segmentectomy in the main is known as treatment for surgery in this process of an anatomic division of a particular lobe of the lung is usually removed.

Pneumonectomy
In this method of surgery by entire lung may be removed for treatment of patient.

Wedge resection e
Removal of section of the Lung is principally known as Wedge resection.

Sleeve/bronchoplastic
In this method removal of an associated tubular section of the associated main bronchial passage during lobotomy with subsequent reconstruction of the bronchial passage is initiated for fast recovery of patient.

Vats lobectomy
This is the method of Surgery by which may allow for diminished pain, quicker return to full activity and diminished hospital costs for patient.

Complications in Thoracic
There are several complications in Thoracic surgery. One of them is significantly a prolonged air leak particularly visible in Lung cancer surgery.

PART 2
Role of social worker in thoracic: In this section role has been analyzed on the basis of personnel interaction with about twenty Social workers from different areas specially related with thoracic surgery. Further, role is explores in the tune of Prevention, support, Treatment and Rehabilitations as mentioned in research proposal.
Medical social workers specialize in public health, geriatric, palliative, and inpatient medical or mental health care. They work in hospitals or other specialized medical settings like nursing homes, rehabilitative care centers, or related home-care services (i.e., hospice).
Some medical social workers are very specialized (i.e. a social worker that serves only patients awaiting transplants or babies receiving neonatal care) while others may serve a larger variety of clients with ongoing medical issues. Medical social workers often collaborate with other medical professionals such as doctors, nurses, discharge coordinators, administrative staff and physical therapists as part of an interdisciplinary team. However, Rehabilitations is upmost primarily related with integration in society as pre normal quince.

Role and Functions of the Medical Social Worker in Overall Dimension of Thoracic Surgery
There are certain functions of the Medical Social Workers culled out through Meta analysis of literature particularly in pre stage and post stage of rehabilitations as follows-

Stages of Role of Medical worker in the area of Thoracic Surgery
However, Role Medical Social Worker in Overall Dimension of Thoracic Surgery may be categorized in Four Stages Namely Pre-Operative Role, At Operative Stage, Post-Operative Stage, and Post-Operative Outcomes Retraction in Pre-Position of Thoracic Surgery.

Stage 1-pre operative role
Pre-operative roles are identified as:

Stage 2-At operative stage
At operative roles are identified as: 1. Surgery and preoperative care, 2. Short term complications and long-term sequelae from Thoracic surgery remain prevalent.

Stage 3-post operative stage
Post-operative roles are recognised as: In the case of Postoperative pulmonary complications (in the case of pneumonia or respiratory failure led to significantly longer length of hospital stay, intensive care admission and death. Following actions may be suggested for specialised critical patients 1-Action for critical Patients who at on critical stage have worse overall and disease-free survival. 2-Patients undergoing major lung resection. The patient can be classified on the basis of age, gender and mental and physical quality. 3-Exercise capacity is a key element in the selection process of patients suitable for thoracic surgery. It is also include action for diagnosis of non-small cell lung cancer and measures of response to exercise predict survival in lung disease.

Stage 4-post operative outcomes
Post-operative outcomes roles are made out as: Postoperative outcomes, specifically hospital length of stay and morbidity, are significantly reduced in comparison with standard care.

Stage 5-retraction in pre-position of thoracic surgery
Retraction in pre-position role are ascertained as: In this stage the role of medical social worker is very critical because they prepare their patients for retraction in their family ultimately for society as normal life before such as psychosocial counseling, grief counseling, case management, and referrals. However, the various operative models have been quelled out in Table 2 on the basis of responses of selected Social Workers who absorb in thoracic surgery. Table 2 depicts that most the social workers agrees with various indicators of promotion, prevention, diagnosis, treatment and rehabilitation in tune of 1 to 5 stages in majority supported. Details of this sine quo non about treatment in Figure 1.
Medical social workers perception facilitated that 78% supported stage 5 prime fasciae, while concerning 97.5% and 81 ipso facto reflected Stage 1. Meanwhile 90% mended that if Stage 2, Stage 3 and Stage 4 then fruitful optimum most wanted role. In the intervening time, deep-seated again 95 % pick up where you left off so far stage 5. As a consequence, Stage 5 may generalized as resuming factor which is crucial to

DISCUSSION
The cardiovascular system speaks about the heart, blood vessels and the blood. Primarily concerns of it to make nutrients useful for healthiness of body and struck out wastage while observing process in the form of energy for completing the entire process of its cycle several organs of body taking ultimate part as per their fixation for their supplement Soirée. Cardiothoracic primarily related with the heart and chest or lungs. It is the field of medicine involved in surgical treatment of organs inside the thorax. Social work is profession trepidation with helping individuals, families, groups and communities to enhance their individual and collective wellbeing. Medical social workers are generally specialized in their specific field. For cardiothoracic they perform several function such as Prevention, Support, Treatment and Rehabilitations at each level from pre to post stage as wheel under wheel which mushrooming the healthiness of patient from this disease and ultimately put forward to retraction in pre-position.

CONCLUSION
On the basis of study, it may be culled out that vascular thoracic surgery is related with thorax and there are several methods of surgery in upgrade advanced method is Lobectomy and Cardiopulmonary bypass (CPB), which can be used for better result but it requires support of every segments of Health promoting system inter alia most of towards look for Social Worker as a preparatory of patient, case management and counsellors. They are not only performs pre-operative role, operative stage, post-operative instance but also upmost required stage as retraction in pre-position of thoracic surgery, ultimately propagated as Rehabilitation. Moreover, a lion shares goes towards them in the arena of Prevention, Treatment and Rehabilitations stages on stages per se Social Worker. A pre and postoperative rehabilitation technique can improve outcomes in patients undergoing thoracic surgery visible sine quo non with treatment.

Future Study
It is paramount to make argue that study can be initiated with the empirical mode at each stage of intervention while comparing with other in its weight age which can reduce the stumbling block in the process of recovery of effected individual as noted disease of Medical Social Worker.

Suggestion
As inferences supports that each five stages have been noting as paramount factor in Cardiothoracic primarily, but stage 5 should be brought greater attention and Stage 2, Stage 3 and Stage 4 facilitated with glimpse of foremost requirements.