Using the Taxonomy: A Standard Vocabulary of Chaplain Activities

Healthcare Chaplaincy for Geriatric Patients: A Quasi-Experimental Study into the Outcomes of Catholic Chaplaincy Interventions in Belgium

The present non-randomized clinical trial examined the short-term outcomes of one-on-one chaplaincy interventions with 416 geriatric patients in Belgium. Participants were interviewed one or two days before a potential chaplaincy intervention (baseline measurement), and one or two days after a potential intervention (post-measurement). Patients in the non-randomized intervention group received an intervention by the chaplain, while the non-randomized comparison group did not. Patients in the intervention group showed a significant decrease in state anxiety and negative affect, and a significant improvement in levels of hope, positive affect, peace, and Scottish PROM-scores, compared to the comparison group. Levels of meaning in life and faith did not significantly change after the chaplaincy intervention. This study suggests that geriatric patients may benefit from chaplaincy care and recommends the integration of chaplaincy care into the care for older adults.

Call the Rezadora: Aiding Latino Families at the End of Life

INTRODUCTION

The rezadora, a lay spiritual leader, provides support to Latino families as they provide end-of-life (EOL) care for loved ones. The purpose of this study was to learn about the work of the rezadora in Guatemala as a resource for Latinos with serious illness in the United States.

METHODS

An ethnographic exploratory case study was conducted during summer 2018 in rural Guatemala. We interviewed three rezadoras who resided in two villages. The study yielded two cases, the single case and the paired case, which allowed for a holistic view of how the rezadora serves the community.

RESULTS

Content and thematic analysis led to two themes: Essence of being called and Power of prayerful song. Essence of being called was represented by the prominence of the rezadora and their perpetual faith work. Power of prayerful song was characterized through the mission, customs, and the presence of the rezadora. A good death was aided by the rezadora in this context.

CONCLUSIONS

As the Latino population ages in place, the need for palliative and EOL care services will increase. Lay spiritual leaders could enhance the palliative care teams in these communities and improve the quality of life for Latinos with serious illness.

The development of an outcome oriented and research informed spiritual care assessment and documentation form for the electronic health record in an adult hospital setting

Standards for professional chaplaincy expect chaplains to document their work in patients' medical records, but no agreed upon standard for the content or format of such documentation exists. With the adoption of Electronic Health Records (EHRs) in many hospitals, chaplains may utilize a provided electronic form or one that can be customized from a basic format to departmental specifications. Ideally, the documentation form supports and reflects the work of chaplains in their specific clinical context. Outcome oriented models of chaplaincy and an increasing focus on a research informed practice of spiritual care should determine the format and content of chaplains' documentation in the EHR. This article describes how a chaplaincy department in an adult academic Level I trauma center designed and implemented a spiritual care documentation form for the EHR. The documentation template is informed by clinical expertise and by research about patients' meaning-making activities and patients' experience of connectedness in the context of illness. It integrates a consensus-based assessment form with narrative documentation options, searchable selections, and an outcome-oriented plan of care.

Chaplaincy Care in the MICU: Describing the Spiritual Care Provided to MICU Patients and Families at the End of Life

BACKGROUND

Gravely ill patients admitted to the intensive care unit (ICU), and their families experience acute spiritual and existential needs and often require complex decisions about their care. Little is known about what constitutes chaplaincy care for patients or families in ICUs. Chaplains report that participation in medical decision-making is part of their role.

OBJECTIVE

To describe the spiritual care provided to patients and their families in the ICU.

METHODS

This was a retrospective observational study of spiritual care for patients and families in the medical ICUs (MICUs) at 4 medical centers over a 3-month period. Inclusion criteria were death in the MICU or discharge to palliative care or hospice. Measures included medical, treatment, and spiritual care information (number of visits, length of visit, chaplain categories, and type of spiritual care provided).

RESULTS

Of the 254 patients, 197 (78%) received a total of 485 spiritual care visits. Seventy-seven percent of visits included provision of emotional/spiritual support; only 15% included decision-making support such as family meetings or goals-of-care conversations. The proportion receiving spiritual care increased as patients neared death or discharge. Staff chaplains were involved in goals-of-care conversations to a greater extent than student or part-time chaplains (P < .05).

CONCLUSION

Spiritual care was provided to most patients and/or families at the end of life. Low chaplain involvement in decision-making in the MICU suggests opportunities to improve chaplains' contributions to ICU care.