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Muehlhausen BL, Chappelle C, DeLaney A, Peacock D, Stratton RG, Fitchett G. Providing spiritual care to cancer patients in the outpatient context: a pilot study. J Health Care Chaplain 2024; 30:153-166. [PMID: 37811644 DOI: 10.1080/08854726.2023.2266303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
The aim of this pilot study was to test an effort to provide spiritual care (SC) to oncology outpatients in the Ascension healthcare system. Medical providers referred patients who would benefit from spiritual and emotional support. Twenty-seven cancer outpatients from 5 states were enrolled in the project. Based on the chaplain assessment, 45% of the patients had moderate or severe spiritual concerns. On average patients had 4 sessions with a chaplain (range 2-9). Of the 136 chaplain sessions, 56% were in-person in the clinic and 35% were by phone. The most common chaplain activities were active listening (87% of the sessions) and demonstrate caring and concern (55%). For the 20 patients who provided follow-up data, there were decreases in all measures of religious/spiritual distress, though statistically insignificant, and a marginally significant increase (p < .054) in well-being. The study adds to the emerging literature that describes the importance of SC in the outpatient context.
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Affiliation(s)
| | | | | | | | | | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA
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2
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Sprik PJ, Vanderstelt H, Valenti-Hein C, Denton J, Ashton D. Chaplain interventions and outcomes in outpatient settings: a scoping review. J Health Care Chaplain 2024:1-23. [PMID: 38836429 DOI: 10.1080/08854726.2024.2357042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
As chaplaincy is increasingly practiced in outpatient settings, further understanding is needed of what it entails and is accomplishing within this unique context. This scoping review summarizes 42 articles that describe the types of spiritual care interventions and programs offered by chaplains in outpatient settings, and their outcomes. Findings support that chaplaincy is practiced in outpatient settings, especially in palliative care, oncology, and primary care. Interventions are delivered by chaplains as the sole interventionist, and by interdisciplinary teams with chaplain participants. Results show that outpatient chaplain interventions are feasible and acceptable, with positive psychological and spiritual outcomes. More studies with consistent outcome measurements, and structured chaplain interventions are needed to draw further conclusions about the effectiveness of outpatient chaplain interventions.
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Affiliation(s)
- Petra J Sprik
- Department of Health Services Administration, University of Alabama at Birmingham (UAB), Birmingham, Alabama
| | - Heather Vanderstelt
- Department of Spiritual Care, St. Joseph's Health Care London, London, Canada
| | | | - Joseph Denton
- Spiritual Health Department, Bon Secours Mercy Health, Cincinnati, OH, USA
| | - Deadra Ashton
- Department of Spiritual Health, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
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3
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Payne T. Chaplaincy and outpatient cancer care in a faith-based health system: lessons learned when imbedding two full time chaplain positions in a cancer institute with a faith-based heritage. J Health Care Chaplain 2024:1-10. [PMID: 38801734 DOI: 10.1080/08854726.2024.2354000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
There is interest in chaplains devoted to outpatient cancer care, informed by a growing body of research as well as recommendations of accreditors. Simultaneously, a growing share of U.S. healthcare is faith-based and possesses a foundational interest in religious/spiritual (R/S) care due to institutional culture. In that milieu, few articles describe how religious organizational cultures influence the creation and implementation of FTEs intended to meet the evidence-based recommendations of accreditors. This is a lacuna, given that board certified chaplains are measured on their ability to integrate spiritual care into the life and service of their institutions. In response, this article describes the creation and implementation of two chaplain positions devoted to a group of outpatient cancer clinics in a large Catholic healthcare system. This includes lessons learned when navigating R/S aspects of organizational cultures while implementing and executing chaplain practice to meet accreditor recommendations.
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4
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Cullen I, Bailes M, Shropshire P, Perry S, Karlekar M. Connecting Families to Bereavement Resources: A Hospital-Based, Bereavement Follow-Up Pilot During First-Wave COVID-19. J Palliat Med 2024; 27:532-536. [PMID: 38346311 DOI: 10.1089/jpm.2023.0375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
Background: Hospitals often lack bereavement programs. Bereaved families often navigate grief support on their own. This problem was complicated by the early COVID-19 pandemic. Objective: Describe a cost neutral pilot to support next of kin (NOK) of deceased patients from our communicable disease response unit (CDRU) and palliative care unit (PCU). Design: Ad hoc pilot leveraging chaplains and a social worker (SW) to call NOK for grief support using a templated guide, referring interested NOK to bereavement support agencies. Setting/Subjects: NOK of patients who died in the CDRU and PCU at a metropolitan, quaternary care, hospital over five months. Results: One hundred eighty-six patients died. Eighty-one NOK were called, 51 calls were considered complete. Fourteen NOK accepted a referral for bereavement support. Conclusions: This cost neutral pilot successfully connected 81 NOK with either a pilot chaplain or SW for bereavement support. Fourteen NOK accepted referral for a community bereavement resource.
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Affiliation(s)
- Ian Cullen
- Vanderbilt University Medical Center, Department of Spiritual and Pastoral Care, Nashville, Tennessee, USA
| | - Melinda Bailes
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Patricia Shropshire
- Vanderbilt University Medical Center, Department of Spiritual and Pastoral Care, Nashville, Tennessee, USA
| | - Sherry Perry
- Vanderbilt University Medical Center, Department of Spiritual and Pastoral Care, Nashville, Tennessee, USA
| | - Mohana Karlekar
- Vanderbilt University Medical Center, Division of Internal Medicine and Public Health, Nashville, Tennessee, USA
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Winiger F. The changing face of spiritual care: current developments in telechaplaincy. J Health Care Chaplain 2023; 29:114-131. [PMID: 35259083 DOI: 10.1080/08854726.2022.2040895] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In recent years, and particularly since the Covid-19 pandemic, telehealth has been rapidly introduced into U.S. healthcare institutions. While preliminary data and best practices are beginning to emerge, it remains unclear how chaplains are responding to this development in practice. Consequently, professional organizations have tended to lag behind the changing demands of increasingly digital professional environments. This article addresses this gap by presenting three case studies of U.S. healthcare settings where chaplains have become an integral component of telehealth infrastructure: the Mercy system, Ascension Health, and the Veteran's Health Administration of the U.S. Department of Veteran Affairs. Based on interviews with chaplains and directors of chaplaincy departments, it shows how the 'telechaplains' at these institutions have adapted to the introduction of telehealth across the continuum of care, and discusses the legal, economic, practical and theological challenges and hopes reported in each case.
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Affiliation(s)
- Fabian Winiger
- UFSP Digital Religion(s), University of Zürich, Zürich, Switzerland
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6
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Sprik PJ, Janssen Keenan A, Boselli D, Grossoehme DH. Chaplains and telechaplaincy: best practices, strengths, weaknesses-a national study. J Health Care Chaplain 2023; 29:41-63. [PMID: 35067213 DOI: 10.1080/08854726.2022.2026103] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Telechaplaincy is the use of telecommunications and virtual technology to deliver religious/spiritual care. It has been used for decades, but chaplains' understanding of telehealth lags behind other disciplines. The purpose of this study was to describe the use of telechaplaincy in the United States and chaplains' perceptions of the practice. Researchers surveyed chaplains through chaplain-certifying-body email-listservs, then conducted in-depth interviews with 36 participants identified through maximum variation sampling. Quantitative analysis and qualitative, thematic analysis were conducted. Quantitative results show that in 2019, approximately half of surveyed chaplains performed telechaplaincy. Rural chaplains were more likely to have practiced. Chaplains who had not practiced were more willing to try if they believed it was effective at meeting religious/spiritual needs. Qualitative findings describe chaplains' perceptions of strengths, weaknesses, and best practices.
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Affiliation(s)
- Petra J Sprik
- Department of Supportive Oncology, Levine Cancer Institute, Charlotte, NC, USA
| | - Angela Janssen Keenan
- Department of Spiritual Care and Education, Atrium Health's Carolinas Medical Center, Charlotte, NC, USA
| | - Danielle Boselli
- Department of Cancer Biostatistics, Levine Cancer Institute, Charlotte, NC, USA
| | - Daniel H Grossoehme
- Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, OH, USA.,Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA
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7
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Earl BSW, Klee A, Edens EL, Cooke JD, Heikkila H, Grau LE. Healthcare Providers' Perceptions about the Role of Spiritual Care and Chaplaincy Services in Substance Use Outpatient Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159441. [PMID: 35954792 PMCID: PMC9367702 DOI: 10.3390/ijerph19159441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023]
Abstract
Addressing patients' religion and spirituality (R/S) needs has been associated with positive health outcomes. However, despite receiving extensive training in spiritual assessment and care, chaplaincy services are primarily confined to inpatient settings, with few studies occurring in outpatient settings. The study sought to understand mental health providers' views about what shaped provider and patient motivation to engage in R/S discussions and seek referrals to chaplaincy services. We conducted five one-hour focus group sessions with a total of 38 staff members and thematically analyzed the resulting session and field notes. We identified four themes concerning provider knowledge and attitudes about R/S and chaplaincy services: Staff Information Needs, Staff Motivation to Discuss R/S and Refer, Patient Motivation to Use Chaplaincy Services, and Chaplain Accessibility. The study findings suggest that providers in outpatient substance use treatment clinics in the Veterans Health Administration are receptive to learning about R/S care and the possibility of expanding chaplaincy services. However, staff have misconceptions about the roles and responsibilities of chaplains. Attitudes about and experiences with R/S discussions varied. Trust and confidence in the benefits of chaplaincy services may be improved among both providers and patients by increasing chaplains' accessibility and visibility within these outpatient settings.
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Affiliation(s)
- Brian S. W. Earl
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Chaplain Services, Veterans Administration Hospital, Albuquerque, NM 87108, USA
| | - Anne Klee
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Ellen L. Edens
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - James D. Cooke
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
| | - Holly Heikkila
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Chaplain Services, Milwaukee Veterans Administration Hospital, Milwaukee, WI 53215, USA
- Spiritual Life Office, University of Chicago, Chicago, IL 60637, USA
| | - Lauretta E. Grau
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06511, USA
- Correspondence: ; Tel.: +1-203-785-2904
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8
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Kestenbaum A, Fitchett G, Galchutt P, Labuschagne D, Varner-Perez SE, Torke AM, Kamal AH. Top Ten Tips Palliative Care Clinicians Should Know About Spirituality in Serious Illness. J Palliat Med 2021; 25:312-318. [PMID: 34871044 DOI: 10.1089/jpm.2021.0522] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Assessment of spiritual suffering and provision of spiritual care are a central component of palliative care (PC). Unfortunately, many PC clinicians, like most medical providers, have received limited or superficial training in spirituality and spiritual distress. This article, written by a group of spiritual care providers, and other PC and hospice clinicians, offers a more in-depth look at religion and spirituality to help to enhance readers' current skills while offering a practical roadmap for screening for spiritual distress and an overview of partnering with colleagues to ensure patients receive values-aligned spiritual care provision.
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Affiliation(s)
- Allison Kestenbaum
- Spiritual Care Services, UC San Diego Health, San Diego, California, USA
| | - George Fitchett
- Department of Religion, Health & Human Values, Rush University Medical Center, Chicago, Illinois, USA
| | - Paul Galchutt
- Spiritual Health Services, M Health Fairview, Minneapolis, Minnesota, USA
| | - Dirk Labuschagne
- Supportive Oncology, Rush University Medical Center, Chicago, Illinois, USA
| | - Shelley E Varner-Perez
- Indiana University (IU) Health, Indianapolis, Indiana, USA.,IU Center for Aging Research, Regenstrief Institute, Inc., Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, Indiana, USA
| | - Alexia M Torke
- Indiana University School of Medicine, Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, Indiana, USA
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9
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Perez SEV, Maiko S, Burke ES, Slaven JE, Johns SA, Smith OJ, Helft PR, Kozinski K, Torke AM. Spiritual Care Assessment and Intervention (SCAI) for Adult Outpatients With Advanced Cancer and Caregivers: A Pilot Trial to Assess Feasibility, Acceptability, and Preliminary Effects. Am J Hosp Palliat Care 2021; 39:895-906. [PMID: 34467769 PMCID: PMC8928229 DOI: 10.1177/10499091211042860] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Although religion and spirituality are important to adults with cancer and their family caregivers, few studies have tested spiritual care interventions in the outpatient setting. AIM To determine the feasibility, acceptability, and preliminary effects of chaplain-delivered, semi-structured spiritual care to adult outpatients with advanced cancer and their caregivers. DESIGN In this pre/post pilot intervention study, board-certified chaplains utilized the Spiritual Care Assessment and Intervention (SCAI) framework during 4 individual sessions. Surveys at baseline and at 1, 6, and 12 weeks post-intervention assessed spiritual well-being, quality of life, depression, anxiety, and religious coping. SETTING/PARTICIPANTS We enrolled U.S. adult outpatients with or without an eligible family caregiver. Eligible patients were at least 18 years old and at least 2 weeks post-diagnosis of incurable and advanced-stage lung or gastrointestinal (GI) cancer. RESULTS Of 82 eligible patients, 24 enrolled (29.3%); of 22 eligible caregivers, 18 enrolled (81.8%). Four planned chaplain visits were completed by 87.5% of patients and 77.8% of caregivers. All enrolled participants completed baseline surveys, and more than 75% completed follow-up surveys at 2 of 3 time points. More than 80% of patients and caregivers reported they would recommend the sessions to a friend or family member. Patients' spiritual well-being improved significantly at all timepoints compared to baseline: 1-week post (p < .006), 6-weeks post (p < .001), and 12-weeks post (p < .004). CONCLUSIONS Spiritual care through SCAI is feasible, acceptable, and shows promise in improving spiritual well-being and other important outcomes in advanced-stage cancer patients and family caregivers. Further investigation is warranted.
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Affiliation(s)
- Shelley E Varner Perez
- Indiana University (IU) Health, Indianapolis, IN, USA.,IU Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA.,Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, IN, USA
| | - Saneta Maiko
- Indiana University (IU) Health, Indianapolis, IN, USA.,Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, IN, USA
| | - Emily S Burke
- IU Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - James E Slaven
- IU Department of Biostatistics and Health Data Science, IU School of Medicine, Indianapolis, IN, USA
| | - Shelley A Johns
- IU School of Medicine, Indianapolis, IN, USA.,IU Center for Health Services Research, Regenstrief Institute, Inc., Indianapolis, IN, USA.,Charles Warren Fairbanks Center for Medical Ethics, IU Health, Indianapolis, IN, USA
| | | | - Paul R Helft
- IU School of Medicine, Indianapolis, IN, USA.,Charles Warren Fairbanks Center for Medical Ethics, IU Health, Indianapolis, IN, USA.,IU Melvin and Bren Simon Cancer Center, Indianapolis, IN. Maiko is now with Indiana Conference, United Methodist Church, Greenwood, Indiana; Smith is now Wright State Boonshoft School of Medicine, Dayton, OH; Kozinski is now with Trinity Health, Waterville, ME
| | | | - Alexia M Torke
- IU Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, IN, USA.,Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, IN, USA.,IU School of Medicine, Indianapolis, IN, USA
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10
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Sherman AC, Simonton-Atchley S, O'Brien CE, Campbell D, Reddy RM, Guinee B, Wagner LD, Anderson PJ. Associations Between Religious/Spiritual Coping and Depression Among Adults with Cystic Fibrosis: A 12-Month Longitudinal Study. JOURNAL OF RELIGION AND HEALTH 2021; 60:2646-2661. [PMID: 33575892 DOI: 10.1007/s10943-021-01185-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 06/12/2023]
Abstract
Individuals with cystic fibrosis (CF) face a challenging disease, and depression is a significant concern. Many patients draw on religious/spiritual resources to assist them in managing the demands of chronic illness; however, these coping efforts rarely have been evaluated among adults with CF. This longitudinal study examined relationships between distinct types of positive and negative religious/spiritual coping at baseline (assessed with the RCOPE) and depression screening outcomes 12 month later (assessed with the Hospital Anxiety and Depression Scale). In logistic regression analyses controlling for disease severity (FEV1% predicted), lower likelihood of depression caseness at 12 months was predicted by higher general religiousness at baseline, greater use of benevolent religious reappraisal coping, greater use of spiritual connection coping, and lower spiritual discontent. Results suggest that distinct aspects religious/spiritual coping have differential associations with subsequent depression outcomes. Findings extend prior research to an important, understudied medical population, and address a clinically meaningful outcome.
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Affiliation(s)
- Allen C Sherman
- Behavioral Medicine Division, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | | | - Catherine E O'Brien
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Dianne Campbell
- Cystic Fibrosis Clinic, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Social Work, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA
| | - Raghu M Reddy
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- St. Vincent's Hospital, Little Rock, AR, USA
| | - Bethany Guinee
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Pharmacy Department, Select Specialty Hospital, Orlando, FL, USA
| | - Laura D Wagner
- Department of Pharmacy Practice, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Primary Care Clinic, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Paula J Anderson
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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11
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Huang LT, Tai CY, Longcoy J, McMillan SC. The Mutual Effects of Perceived Spiritual Needs on Quality of Life in Patients With Advanced Cancer and Family Caregivers. J Hosp Palliat Nurs 2021; 23:323-330. [PMID: 34185726 PMCID: PMC8243389 DOI: 10.1097/njh.0000000000000758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Perceived spiritual needs may increase when patients with advanced cancer and their family caregivers are confronted with the challenges of physical and psychological distress. Given the intertwined relationships between patients and family caregivers, their interdependence should be considered to understand how perceived spiritual needs affect the quality of life of their own and of their partner. This study used the Actor-Partner Interdependence Model as the conceptual model to investigate the mutual effects of perceived spiritual needs on the quality of life in patients with advanced cancer and their family caregivers after being admitted to hospice. This cross-sectional study used the baseline data of a large clinical trial and identified that patients with cancer and their family caregivers perceived similar spiritual needs associated with the community and outlook needs and had fewer unmet spiritual needs. After controlling for partner effects, perceived outlook needs shown in patients significantly predicted their own functional well-being and social/spiritual well-being. Outlook and community needs perceived by family caregivers also significantly predicted their own mental health. Although partner effects were not shown as expected, the findings provide insight into the mutuality of spirituality and demonstrate the necessity of providing timely and ongoing spiritual assessment and care.
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Affiliation(s)
- Li-Ting Huang
- College of Nursing, University of Illinois at Chicago
| | - Chun-Yi Tai
- School of Nursing, National Taipei University of Nursing and Health Sciences
| | - Joshua Longcoy
- Center for Community Health Equity, Rush University Medical Center
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12
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Handzo G, Hughes B, Bowden J, Kelly B, Lynch J, Mercier M, Pavlantos C, Rothstein H, Tuttle M. Chaplaincy in the outpatient setting-getting from here to there. J Health Care Chaplain 2020; 28:194-207. [PMID: 32981466 DOI: 10.1080/08854726.2020.1818359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
One of the most evident trends in US health care and health care generally in the developed world is that more and more care is shifting to outpatient settings. This change opens up substantial opportunities, and in many cases, expectations for chaplains to extend the breadth of the care they provide in any health system. However, it also brings many challenges. This paper describes the journey of four very different inpatient chaplaincy services into the outpatient setting. These four examples focus on settings that would historically be thought of as outpatient-those that see patients within the brick and mortar of the health system.
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Affiliation(s)
| | - Brian Hughes
- HealthCare Chaplaincy Network, New York, NY, USA
| | - Jill Bowden
- HealthCare Chaplaincy Network, New York, NY, USA.,Memorial SloanKettering Cancer Center, New York, NY, USA
| | - Brian Kelly
- HealthCare Chaplaincy Network, New York, NY, USA.,Memorial SloanKettering Cancer Center, New York, NY, USA
| | - Jacqueline Lynch
- HealthCare Chaplaincy Network, New York, NY, USA.,St. Mary's Hospital for Children, Queens, NY, USA
| | - Michael Mercier
- HealthCare Chaplaincy Network, New York, NY, USA.,LifeSpan Health System, Providence, RI, USA
| | - Clio Pavlantos
- HealthCare Chaplaincy Network, New York, NY, USA.,Memorial SloanKettering Cancer Center, New York, NY, USA
| | - Harry Rothstein
- HealthCare Chaplaincy Network, New York, NY, USA.,Memorial SloanKettering Cancer Center, New York, NY, USA
| | - Margaret Tuttle
- HealthCare Chaplaincy Network, New York, NY, USA.,Hospital for Special Surgery, New York, NY, USA
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13
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Feasibility and acceptability of a telephone-based chaplaincy intervention in a large, outpatient oncology center. Support Care Cancer 2020; 29:1275-1285. [PMID: 32623520 PMCID: PMC7334628 DOI: 10.1007/s00520-020-05598-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022]
Abstract
Purpose Telechaplaincy (the use of telecommunications and virtual technology to deliver spiritual and religious care by healthcare chaplains or other religious/spiritual leaders) is a relatively novel intervention that has increasingly been used in recent years, and especially during COVID-19. Telephone-based chaplaincy is one mode of telechaplaincy. The purpose of this study was to (1) describe telephone-based chaplaincy interventions delivered as the first point of contact to patients who screen positive for religious/spiritual concern(s) using an electronic data system, and (2) assess the feasibility and acceptability of delivering interventions in an outpatient cancer institute using this methodology. Methods Patients were screened for religious and spiritual (R/S) concern(s) using an electronic data system. Patients indicating R/S concern(s) were offered a telephone-based chaplaincy intervention and asked to complete a survey assessing acceptability of the intervention. Feasibility and acceptability data were collected. Results Thirty percent of screened patients indicated R/S concern(s). Telephone-based chaplaincy interventions were offered to 100% of eligible patients, establishing contact with 61% of eligible patients, and offering chaplaincy interventions to 48% of those patients. Survey participants report high acceptability of the offered intervention. Conclusion This is the first study examining feasibility and acceptability of telephone-based chaplaincy with oncology patients. Telephone-based chaplaincy is feasible and acceptable within an outpatient oncology setting, supporting the promise of this interventional strategy. Further research is needed to refine practices.
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14
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Lion AH, Skiles JL, Watson BN, Young JD, Torke AM. Chaplain care in pediatric oncology: Insight for interprofessional collaboration. Pediatr Blood Cancer 2019; 66:e27971. [PMID: 31429523 DOI: 10.1002/pbc.27971] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although attending to spiritual and religious needs is part of high quality care of pediatric cancer patients, oncology clinicians may not understand the role of the chaplain, resulting in underutilization of resources and failure to fully integrate the chaplain into the clinical team. We provide a description of what the chaplain does in the care of pediatric oncology patients. METHODS We conducted a qualitative content analysis of chaplain chart notes over a one-year period on the pediatric oncology service at a freestanding children's hospital. Using criteria designed to capture multiple potential factors in chaplain referral, we selected 30 patients for thematic analysis. RESULTS In 2016, 166 pediatric patients were diagnosed with cancer and received ongoing care at our institution. From the 30 patients selected, 230 chaplain encounters were documented in the medical chart. Three major themes emerged. (1) The chaplains provided a rich description of spiritual and psychosocial aspects of the patient and family's experience; (2) chaplains provided diverse interventions, both religious and secular in nature; and (3) chaplains provided care within a longitudinal relationship. All three themes depend on the empathic listening by a chaplain. CONCLUSIONS The chaplains' observations about patient and family beliefs, experiences, and emotional/spiritual states have the potential to inform the interdisciplinary care of the patient. Chaplain documentation provides insight into how spiritual care interventions and close relationships may promote patient and family well-being. In future work, we will explore how to give voice to their insights in caring for pediatric oncology patients.
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Affiliation(s)
- Alex H Lion
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana.,Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indianapolis, Indiana
| | - Jodi L Skiles
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.,Indiana University School of Medicine, Indianapolis, Indiana
| | | | - J Daniel Young
- Mississippi United Methodist Conference, Jackson, Mississippi
| | - Alexia M Torke
- Indiana University School of Medicine, Indianapolis, Indiana.,Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, Indianapolis, Indiana.,Indiana University Center for Aging Research, Regenstrief Institute, Indianapolis, Indiana
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