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Marin DB, Karol AB, Sharma V, Wetmore J, Costello Z, Henry B, Robinson M, Thompson L, Peña I, Jandorf L. M.I.C.A.H. Project HEAL: Sustainability of a Faith-Based Community Health Advisor Training Program in Urban Underserved Communities in the USA. JOURNAL OF RELIGION AND HEALTH 2022; 61:2527-2538. [PMID: 34751869 DOI: 10.1007/s10943-021-01453-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
Faith-based organizations (FBOs) can play an important role in improving health outcomes. Lay community health advisors (CHAs) are integral to these efforts. This paper assesses the sustainability of a CHA training program for congregants in African-American and Latino FBOs and subsequent implementation of educational workshops. The program is unique in that a health care chaplain in an academic medical center was central to the program's development and implementation. Forty-eight CHAs in 11 FBOs were trained to teach workshops on cardiovascular health, mental health, diabetes, and smoking cessation. Two thousand four hundred and forty-four participants attended 70 workshops. This program has the potential to be a model to educate individuals and to address health inequities in underserved communities. Health care chaplains in other medical centers may use this as a model for enhancing community engagement and education.
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Affiliation(s)
- Deborah B Marin
- Center for Spirituality and Health, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.
| | - Alex B Karol
- Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Vansh Sharma
- Center for Spirituality and Health, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - John Wetmore
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Zorina Costello
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Brittney Henry
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
| | - Mimsie Robinson
- Bethel Gospel Assembly, 2-26 East 120th Street, New York, NY, 10035, USA
| | - Linda Thompson
- Health Ministry Leader, Abyssinian Baptist Church, 132 Odell Clark Place, New York, NY, 10030, USA
| | - Israel Peña
- Department of Psychology, Boricua College, Bronx, NY, 10451, USA
- The FLOW Kingdom Ministries, 901 East Tremont Avenue, Bronx, NY, 10460, USA
| | - Lina Jandorf
- Department of Population Health and Health Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA
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Spirituality in a Doctor's Practice: What Are the Issues? J Clin Med 2021; 10:jcm10235612. [PMID: 34884314 PMCID: PMC8658590 DOI: 10.3390/jcm10235612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/17/2021] [Accepted: 11/20/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: It is becoming increasingly important to address the spiritual dimension in the integral care of the people in order to adequately assist them in the processes of their illness and healing. Considering the spiritual dimension has an ethical basis because it attends to the values and spiritual needs of the person in clinical decision-making, as well as helping them cope with their illness. Doctors, although sensitive to this fact, approach spiritual care in clinical practice with little rigour due to certain facts, factors, and boundaries that are assessed in this review. Objective: To find out how doctors approach the spiritual dimension, describing its characteristics, the factors that influence it, and the limitations they encounter. Methodology: We conducted a review of the scientific literature to date in the PubMed, Scopus, and CINAHL databases of randomised and non-randomised controlled trials, observational studies, and qualitative studies written in Spanish, English, and Portuguese on the spiritual approach adopted by doctors in clinical practice. This review consisted of several phases: (i) the exclusion of duplicate records; (ii) the reading of titles and abstracts; (iii) the assessment of full articles and their methodological quality using the guidelines of the international Equator Network. Results: A total of 1414 publications were identified in the search, 373 of which were excluded for being off-topic or repeated in databases. Of the remaining 1041, 962 were excluded because they did not meet the inclusion criteria. After initial screening, 79 articles were selected, from which 17 were collected after reading the full text. A total of 8 studies were eligible for inclusion. There were three qualitative studies and five cross-sectional observational studies with sufficient methodological quality. The results showed the perspectives and principal characteristics identified by doctors in their approach to the spiritual dimension, with lack of training, a lack of time, and fear in addressing this dimension in the clinic the main findings. Conclusions: Although more and more scientific research is demonstrating the benefits of spiritual care in clinical practice and physicians are aware of it, efforts are needed to achieve true holistic care in which specific training in spiritual care plays a key role.
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Van Nieuw Amerongen-Meeuse JC, Schaap-Jonker H, Anbeek C, Braam AW. Religious/spiritual care needs and treatment alliance among clinical mental health patients. J Psychiatr Ment Health Nurs 2021; 28:370-383. [PMID: 32890450 DOI: 10.1111/jpm.12685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 07/08/2020] [Accepted: 08/03/2020] [Indexed: 11/26/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The relationship between patient and professional is one of the cornerstones of successful treatment in mental health care. For part of the mental health patients, a similar outlook on life with their caregiver(s) is important. Attention to religion/spirituality (R/S) in mental health care is likely to influence the relationship between a patient and mental health professional, for patients preferring so. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Patients, who appreciate and experience personalized attention to R/S in conversations with practitioners and nurses, are likely to receive the highest therapeutic benefit from their relationship with their mental health professionals Patients who welcome personalized attention to R/S in conversations but find themselves unsupported in this regard experience significantly lower levels of treatment alliance than do those whose needs are met or those who do not express such needs For religious and nonreligious patients attaching importance to a similar outlook on life with practitioner or nurse, this experience was also related to a better relationship, compared with patients preferring so but experiencing a different outlook on life. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Personalized attention to R/S in conversations is recommended, both for practitioners and nurses. In case of a different outlook on life between a patient and mental health professional, addressing R/S with an open and respectful attitude may prevent negative effects on a patient's treatment experience. ABSTRACT: Introduction Attention to religion and spirituality (R/S) in mental health care has increased and may benefit treatment alliance. Aim To describe the association of (un)met R/S care needs with treatment alliance and compliance among mental health patients. Methods Patients in a Christian and a secular mental health clinic (n = 201) filled in a questionnaire. Scales of met and unmet R/S care needs (range 0-14) were regressed on the Working Alliance Inventory (WAI), Service Engagement Scale and Medication Adherence Report Scale. Ancova analyses were performed for the fourteen R/S care needs separately. Results In the Christian clinic, met R/S care needs were associated with a higher WAI score (p = .001) and unmet R/S care needs, with a lower WAI score (p = .000). For the Secular clinic, the same trends were observed, but insignificant. Items with the strongest associations were conversations about religious distress with a nurse (p = .000) and a similar outlook on life with practitioner (p = .001) or nurse (p = .005). (Un)met R/S care needs were not associated with treatment compliance. Discussion and implications for practice We recommend personalized attention to R/S in conversations. A (perceived) similar outlook on life with mental health professionals may be beneficial for religious and nonreligious patients.
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Affiliation(s)
- Joke C Van Nieuw Amerongen-Meeuse
- Department of Humanist Chaplaincy Studies for a Plural Society, University of Humanistic Studies, Utrecht, The Netherlands.,Center for Research and Innovation in Christian Mental Health Care, Amersfoort, The Netherlands
| | - Hanneke Schaap-Jonker
- Center for Research and Innovation in Christian Mental Health Care, Amersfoort, The Netherlands.,Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Christa Anbeek
- Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Arjan W Braam
- Department of Humanist Chaplaincy Studies for a Plural Society, University of Humanistic Studies, Utrecht, The Netherlands.,Department of Emergency Psychiatry and Residency Training, Altrecht Mental Health Care, Utrecht, The Netherlands
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van Nieuw Amerongen-Meeuse JC, Schaap-Jonker H, Hennipman-Herweijer C, Anbeek C, Braam AW. Patients' Needs of Religion/Spirituality Integration in Two Mental Health Clinics in the Netherlands. Issues Ment Health Nurs 2019; 40:41-49. [PMID: 30273504 DOI: 10.1080/01612840.2018.1475522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION In the last decades, the attention for religion/spirituality (R/S) in mental health care (MHC) has considerably increased. However, patients' preferences concerning R/S in treatment have not often been investigated. The aim of this study was to find out how patients in clinical multidisciplinary MHC want R/S to be addressed in their care. METHODS Thirty-five semi-structured interviews were carried out between September 2015 and July 2016 among patients in a secular and a Christian MHC in the Netherlands. Qualitative inductive content analysis was performed, using Atlas Ti. RESULTS Patients appreciated (1) individual R/S conversations between patients and care team members (mainly nurses), (2) a familiar R/S environment, (3) a special R/S program and (4) contact with their R/S network. Patients varied in their presentation of R/S care needs from (a) explicit, mostly in the Christian MHC, to (b) implicit, predominantly in the secular MHC, or showed (c) hidden R/S care needs. A non-acute stage of the illness and R/S affinity of the mental health professionals, were classified as possible conditions for addressing R/S. Discussion and implications for practice: Nurses are recommended to be aware of the diversity of patients' R/S care needs. Actively addressing R/S may help in recognizing implicit or even hidden R/S care needs. Further considerations on whether and how to respond to patients' R/S care needs would be justified.
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Affiliation(s)
- Joke C van Nieuw Amerongen-Meeuse
- a Department of Globalization and Dialogue Studies , University of Humanistic Studies , Utrecht , the Netherlands.,b Center for Research and Innovation in Christian Mental Health Care Eleos/de Hoop , Amersfoort , the Netherlands
| | - Hanneke Schaap-Jonker
- b Center for Research and Innovation in Christian Mental Health Care Eleos/de Hoop , Amersfoort , the Netherlands
| | | | - Christa Anbeek
- d Department of Religion and Theology , Free University , Amsterdam , the Netherlands
| | - Arjan W Braam
- a Department of Globalization and Dialogue Studies , University of Humanistic Studies , Utrecht , the Netherlands.,e Departments of Emergency Psychiatry and Residency Training , Altrecht Mental Health Care , Utrecht , the Netherlands
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Atkinson HG, Fleenor D, Lerner SM, Poliandro E, Truglio J. Teaching Third-Year Medical Students to Address Patients' Spiritual Needs in the Surgery/Anesthesiology Clerkship. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2018; 14:10784. [PMID: 30800984 PMCID: PMC6354800 DOI: 10.15766/mep_2374-8265.10784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 11/04/2018] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Despite many patients wanting physicians to inquire about their religious/spiritual beliefs, most physicians do not make such inquiries. Among physicians who do, surgeons are less likely than family and general practitioners and psychiatrists to do so. METHODS To address this gap, we developed a 60-minute curriculum that follows the Kolb cycle of experiential learning for third-year medical students on their surgery/anesthesiology clerkship. The session includes definitions of religion/spirituality, an overview of the literature on spirituality in surgery, a review of the FICA Spiritual History Tool, discussion of the role of the chaplain and the process of initiating a chaplain consult, and three cases regarding the spiritual needs of surgical patients. RESULTS In total, 165 students participated in 10 sessions over 13 months. Of these, 120 students (73%) provided short-term feedback. Overall, 82% rated the session above average or excellent, and 72% stated the session was very relevant to patient care. To improve the session, students recommended assigning key readings, discussing more cases, role-playing various scenarios, inviting patients to speak, practicing mock interviews, and allowing for more self-reflection and discussion. Long-term feedback was provided by 105 students (64%) and indicated that the spirituality session impacted their attitudes about the role of religion/spirituality in medicine and their behaviors with patients. DISCUSSION We have designed a successful session on spirituality for third-year students on their surgery/anesthesiology clerkship. Students reported it to be a positive addition to the curriculum. The session can be modified for other surgical subspecialties and specialties outside of surgery.
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Affiliation(s)
- Holly G. Atkinson
- Clinical Professor, CUNY School of Medicine; Assistant Professor of Medicine, Department of Medical Education, Icahn School of Medicine at Mount Sinai
| | - David Fleenor
- Director of Education, Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai
| | - Susan M. Lerner
- Associate Professor, Department of Surgery, Icahn School of Medicine at Mount Sinai; Associate Professor, Department of Medical Education, Icahn School of Medicine at Mount Sinai
| | - Edward Poliandro
- Assistant Clinical Professor, Department of Medical Education, Icahn School of Medicine at Mount Sinai; Assistant Clinical Professor, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai; Senior Associate Director, Education and Training, Office of Diversity and Inclusion, Mount Sinai Health System
| | - Joseph Truglio
- Assistant Professor, Art and Science of Medicine, Department of Medical Education, Icahn School of Medicine at Mount Sinai; Co-Director, Art and Science of Medicine, Department of Medical Education, Icahn School of Medicine at Mount Sinai
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Cangussu Silva A, Ezequiel ODS, Damiano RF, Granero Lucchetti AL, DiLalla LF, Dorsey JK, Lucchetti G. Translation, Transcultural Adaptation, and Validation of the Empathy, Spirituality, and Wellness in Medicine Scale to the Brazilian Portuguese Language. TEACHING AND LEARNING IN MEDICINE 2018; 30:404-414. [PMID: 29630412 DOI: 10.1080/10401334.2018.1445532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 01/11/2018] [Accepted: 02/06/2018] [Indexed: 06/08/2023]
Abstract
Construct: The Empathy, Spirituality, and Wellness in Medicine Scale (ESWIM) is a 43-item multidimensional scale developed to investigate different dimensions of physicians and medical students. Background: Medical education research requires the use of several different instruments with dozens of items that evaluate each construct separately, making their application slow and increasing the likelihood of students providing a large number of incomplete or missing responses. To provide an alternative measure, this study aims to translate, adapt, and validate the multidimensional ESWIM instrument for Brazilian medical students. This is a very promising instrument because it is multidimensional, relatively short, and cost free; it evaluates important constructs; and it has been explicitly designed for use in the medical context. Approach: The English-language instrument was translated and adapted into the Brazilian Portuguese language using standard procedures: translation, transcultural adaptation, and back-translation. ESWIM was administered to students in all years of the medical curriculum. A retest was given 45 days later to evaluate reliability. To assess validity, the questionnaire also included sociodemographic data, the Duke Religion Index, the Empathy Inventory, the brief version of the World Health Organization Quality of Life (WHOQOL-Bref), and the Oldenburg Burnout Inventory. Results: A total of 776 medical students (M age = 22.34 years, SD = 3.11) were assessed. The Brazilian Portuguese version of ESWIM showed good internal consistency for the factor of Empathy (α = 0.79-0.81) and borderline internal consistency for the other factors: Openness to Spirituality (α = 0.61-0.66), Wellness (α = 0.57-0.68), and Tolerance (α = 0.56-0.65). The principal component analysis revealed a four-factor structure; however, the confirmatory factor analysis showed a better fit for a three-factor structure. We found a significant positive correlation between ESWIM empathy and empathy measured by the Empathy Inventory (r = .444, p < .01), as well as negative correlations between ESWIM empathy and burnout (r = -.145 to -.224, p < .01). ESWIM openness to spirituality was also significantly correlated with different subscales of religiosity (r = .301-.417, p < .01), and ESWIM wellness was significantly correlated with the WHOQOL-Bref factors (r = .390-.673, p < .01). The test-retest reliability (applied to 83 students) was high for all factors except Tolerance. Conclusion: This study provides supportive evidence regarding the reliability and validity of ESWIM empathy scores. The ESWIM scale opens a new field of research in relation to openness to spirituality by introducing a scale that measures this openness attitude. Despite borderline internal consistency, ESWIM wellness was strongly associated with quality of life and had good test-retest reliability. Thus, ESWIM appears to be a valid option for evaluating these constructs in medical students.
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Affiliation(s)
- Alexander Cangussu Silva
- a Department of Medical Education , School of Medicine, Federal University of Juiz de Fora , Brazil
| | | | - Rodolfo Furlan Damiano
- a Department of Medical Education , School of Medicine, Federal University of Juiz de Fora , Brazil
| | | | - Lisabeth Fisher DiLalla
- b Department of Family and Community Medicine , Southern Illinois University School of Medicine , Carbondale , Illinois , USA
| | - J Kevin Dorsey
- c Department of Medical Education , Southern Illinois University School of Medicine , Springfield , Illinois , USA
| | - Giancarlo Lucchetti
- a Department of Medical Education , School of Medicine, Federal University of Juiz de Fora , Brazil
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Gonçalves LM, Osório IHS, Oliveira LL, Simonetti LR, Dos Reis E, Lucchetti G. Learning from Listening: Helping Healthcare Students to Understand Spiritual Assessment in Clinical Practice. JOURNAL OF RELIGION AND HEALTH 2016; 55:986-999. [PMID: 26515368 DOI: 10.1007/s10943-015-0146-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We aim to evaluate the perceptions of healthcare students while taking a spiritual history (SH). Fifty students were trained on how to take a SH, interviewed inpatients and answered a questionnaire concerning their perceptions. A total of 362 patients were interviewed: 60.1% of students felt comfortable taking a SH, 85.1% believed the patient liked the approach, and 72.1% believed more benefits could come with a follow-up. When students felt more comfortable, they tended to believe the patient: liked the approach (p < 0.01), felt better (p < 0.01) and more motivated (p < 0.01). Spirituality/health educational strategies may be a valid strategy to prepare future health professionals to face spiritual issues in health scenarios.
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Affiliation(s)
- Lídia Maria Gonçalves
- Department of Medicine, Federal University of Mato Grosso do Sul, Gilbués Street, 76 - Jd. Panamá II, 79113010, Campo Grande, MS, Brazil.
| | - Igraíne Helena Scholz Osório
- Department of Medicine, Federal University of Mato Grosso do Sul, Gilbués Street, 76 - Jd. Panamá II, 79113010, Campo Grande, MS, Brazil
| | - Luan Leal Oliveira
- Department of Medicine, Federal University of Mato Grosso do Sul, Gilbués Street, 76 - Jd. Panamá II, 79113010, Campo Grande, MS, Brazil
| | - Lígia Rodrigues Simonetti
- Department of Medicine, Federal University of Mato Grosso do Sul, Gilbués Street, 76 - Jd. Panamá II, 79113010, Campo Grande, MS, Brazil
| | - Edilson Dos Reis
- Hospital Chaplaincy, University Hospital Maria Aparecida Pedrossian, Campo Grande, Brazil
| | - Giancarlo Lucchetti
- Department of Medicine, Federal University of Juiz de For a, Juiz de Fora, Brazil
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