1
|
Costeira C, Querido A, Ventura F, Loureiro H, Coelho J, Benito E, Nabal M, Dones M, Specos M, Laranjeira C. Spiritual Care[Givers] Competence in Palliative Care: A Scoping Review. Healthcare (Basel) 2024; 12:1059. [PMID: 38891134 PMCID: PMC11171750 DOI: 10.3390/healthcare12111059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
To deliver spiritual care, professionals must be skilled in physical, mental, social, and spiritual care. Spiritual care competence includes knowledge, behaviors, attitudes, and skills that enable successful or efficient care. This review aims to identify the scope of competence and the specific skills, knowledge, and attitudes used in providing spiritual care to people needing palliative care, and the main challenges and facilitators. A scoping review was developed using the Joanna Briggs Institute methodology. Six databases (Web of Science; MEDLINE/Pubmed; Scopus; CINAHL; MedicLatina and SciELO) were searched in September 2023, with an update in January 2024. The resulting 30 articles were analyzed using a content analysis approach. Information was categorized into three domains: cognitive, affective, and functional (based on three personal resources: intrapersonal, interpersonal, and transpersonal). Palliative care professionals face a lack of training and insufficient preparation to deliver spiritual care. Spiritual care competence depends on professional spiritual development and experience, spiritual intelligence (cognitive), spiritual humility (affective), and having a critical and reflexive mind (functional). In the future, palliative care should seek to improve competent spiritual care. This review could help clarify the real configuration of competent spiritual care and lead to improvements in a professional's empowerment when delivering effective spiritual care to patients and families.
Collapse
Affiliation(s)
- Cristina Costeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (A.Q.); (J.C.)
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal; (F.V.); (H.L.)
| | - Ana Querido
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (A.Q.); (J.C.)
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, 4200-450 Porto, Portugal
| | - Filipa Ventura
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal; (F.V.); (H.L.)
| | - Hugo Loureiro
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal; (F.V.); (H.L.)
| | - Joana Coelho
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (A.Q.); (J.C.)
| | - Enric Benito
- Forum Ibero Americano de Espiritualidad, Fundacion SECPAL, C. Sta. Isabel n 51 Centro, 28012 Madrid, Spain; (E.B.); (M.D.); (M.S.)
| | - Maria Nabal
- Forum Ibero Americano de Espiritualidad, Fundacion SECPAL, C. Sta. Isabel n 51 Centro, 28012 Madrid, Spain; (E.B.); (M.D.); (M.S.)
- Palliative Cares Supportive Team, Hospital Universitario Arnau de Vilanova de Lleida, Universidad de Lleida, 25198 Lleida, Spain
| | - Monica Dones
- Forum Ibero Americano de Espiritualidad, Fundacion SECPAL, C. Sta. Isabel n 51 Centro, 28012 Madrid, Spain; (E.B.); (M.D.); (M.S.)
- Palliative Care Hospital Support Team, The Ramón y Cajal University Hospital of Madrid, 28034 Madrid, Spain
- Departamento de Enfermería, Facultad de Medicina, Autonomous University of Madrid, Calle del Arzobispo Morcillo, n° 4, 28029 Madrid, Spain
| | - Marcela Specos
- Forum Ibero Americano de Espiritualidad, Fundacion SECPAL, C. Sta. Isabel n 51 Centro, 28012 Madrid, Spain; (E.B.); (M.D.); (M.S.)
- Institute Pallium Latin-American, Bonpland 2287, Buenos Aires 1425, Argentina
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal; (A.Q.); (J.C.)
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| |
Collapse
|
2
|
Suda S, Burkbauer L, White B, Browning J, DeLisser HM. Medical Students' Reflections on Their Experiences in a Trauma Chaplain Shadowing Program. Am J Hosp Palliat Care 2023; 40:1124-1131. [PMID: 36592479 DOI: 10.1177/10499091221149192] [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: 01/04/2023] Open
Abstract
The importance of spirituality in patient care is well recognized and efforts to develop educational opportunities to improve medical students' competency in spirituality and health are ongoing. In this regard, shadowing of healthcare chaplains has emerged as an experiential approach for providing exposure to and instruction in issues of spirituality in the patient experience and in patient care. Recently published data suggest that a 6-8 hour experience of shadowing a trauma chaplain is effective at introducing first-year medical students to healthcare chaplaincy, difficult spiritual conversations with patients and families, and interprofessional collaboration. As a follow-up to these data, this study provides a qualitative analysis of student reflections written immediately after their shadowing experience with the goal of further characterizing the educational impact of trauma chaplain shadowing. Qualitative analysis of 90 anonymous, student reflections indicated that trauma chaplain shadowing was an experience that provided insights about nature of chaplaincy, enabled opportunities to closely observe the relational skills of chaplains, allowed students to bear witness to suffering, fostered growth toward a professional identity, and facilitated recognition of shortcomings in medical education and clinical medicine. These data therefore provide further evidence of the value of chaplain shadowing in not only enhancing students' understanding of various dimensions of spirituality and medicine but also in promoting their development of a strong physician identity.
Collapse
Affiliation(s)
- Seiji Suda
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Burkbauer
- Department of Surgery, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Betty White
- Department of Pastoral Care and Education, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - James Browning
- Department of Pastoral Care and Education, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Horace M DeLisser
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
3
|
Fopka-Kowalczyk M, Groves R, Larkin P, Krajnik M. A training programme for medical students in providing spiritual care to people with advanced diseases and their loved ones: A case study from the Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland. Front Cardiovasc Med 2022; 9:909959. [PMID: 36247435 PMCID: PMC9558733 DOI: 10.3389/fcvm.2022.909959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/12/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose This article presents the first programme on spiritual care particularly for people with advanced life-limiting illness including heart failure, lung disease or cancer for medical students in Poland implemented at the Collegium Medicum in Bydgoszcz of the Nicolaus Copernicus University in Toruń. Methods and materials Several steps were identified for the development of the first programme on spirituality for medical students at the Collegium Medicum in Bydgoszcz including preliminary work on the content of the programme, agreement on key concepts, terms, and definitions; consultations with teachers and review of the literature. Results The first Polish spiritual curriculum for medical students was implemented. The spirituality curriculum will potentially contribute to better care for the people with advanced illnesses such as heart failure, chronic lung disease or cancer and improve the quality of relationships between professionals and patients. Conclusion The article presents the content of the program, the expected learning objectives and ascribed teaching methods, along with the preliminary evaluation made by students.
Collapse
Affiliation(s)
| | | | - Philip Larkin
- Palliative and Supportive Care Service, Chair of Palliative Care Nursing, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- *Correspondence: Philip Larkin
| | - Małgorzata Krajnik
- Department of Palliative Care, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Crozier D, Greene A, Schleicher M, Goldfarb J. Teaching spirituality to medical students: a systematic review. J Health Care Chaplain 2021; 28:378-399. [PMID: 34137668 DOI: 10.1080/08854726.2021.1916332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Though it has become increasingly clear that religion and spirituality are important aspects of whole patient care, little is known about how this topic is taught to medical students. This systematic review examined the structure of courses teaching spirituality to medical students and assessed their impact on reported student outcomes. METHODS In October 2020, the authors conducted a systematic review of the literature from 1926 to 2020 to identify published articles describing medical school spirituality curricula. Included studies were English-language articles that described spirituality courses predominantly designed for medical students, specified a curricular structure, and evaluated outcomes of the course. The authors used the Medical Education Research Study Quality Instrument (MERSQI) to assess the quality of the included studies and summarized course structures, curricular content, and study outcomes. RESULTS Nineteen publications of the 1889 reviewed met the inclusion criteria. These studies were of moderate quality (mean MERSQI = 9.9). The majority of curricula were taught in United States medical schools. Courses were evenly split between mandatory versus elective classes, with mandatory courses having a shorter duration and higher total student participation. Most studies with clear student outcome evaluation had a pre- and post-test design. Common themes throughout the curricula included teaching how to take a spiritual history, delineating differences between spirituality and religion, and experience shadowing chaplains interacting with patients. CONCLUSIONS This broad systematic review of the literature revealed a small but growing number of studies describing specific course structure and curricula for teaching spirituality at the medical student level. For the most concise approach, one short, mandatory didactic session followed by application with standardized or hospital patients can be an effective method of introducing students to the importance of spirituality. Important topics to address include the differences between religion and spirituality, recognizing spiritual distress, how to take a spiritual history, and the relevance of spirituality to student well-being. Measured student outcomes should encompass behavioral changes during patient care in addition to changes in knowledge and attitudes. Suggested methods of evaluation include reflective writing and adding a standardized patient case in which the patient is in spiritual distress in an Objective Structured Clinical Examination (OSCE).
Collapse
Affiliation(s)
- Dena Crozier
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Amy Greene
- Center for Spiritual Care, Cleveland Clinic, Cleveland, OH, USA
| | - Mary Schleicher
- Floyd D. Loop Medical Library, Cleveland Clinic, Cleveland, OH, USA
| | - Johanna Goldfarb
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|