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Miller M, Rosa WE, Buller H, McDarby M, Ferrell BR. "I Often Just Don't Know what to Say!": Variations in Multidisciplinary Palliative Care Clinicians' Confidence and Needs Related to Spiritual Care. Am J Hosp Palliat Care 2024:10499091241265108. [PMID: 39039027 DOI: 10.1177/10499091241265108] [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: 07/24/2024] Open
Abstract
BACKGROUND Spiritual care is a core component of high-quality palliative care, yet gaps exist in spiritual care provision. Understanding clinicians' levels of confidence around spiritual care and their perceptions of necessary knowledge/skills to enhance their ability to provide spiritual care is foundational for improving delivery of spiritual care in practice. OBJECTIVES To understand confidence levels with providing spiritual care and perceived needs in relation to the provision of spiritual care among palliative clinicians (nurses, social workers, chaplains). DESIGN N = 260 clinicians participating in interprofessional communication and end-of-life care training programs completed a structured survey. MEASUREMENTS Clinicians responded to 42 closed-ended questions assessing their confidence in engaging in spiritual care across 6 dimensions, and one open-ended question: "What areas of knowledge or skill would best help to improve your ability to provide spiritual care across diverse populations?" RESULTS Findings reveal varied levels of confidence with spiritual care across dimensions. Chaplains reported the highest levels of confidence compared with nurses and social workers. Key areas of knowledge/skills to improve spiritual care provision were: (1) Training and support for clinicians in spiritual care; (2) Strategies for providing spiritual care to patients from diverse cultural and/or religious backgrounds; (3) Better understanding of specific populations and contexts that may affect spiritual care provision; and (4) Clinicians' personal growth & practices to improve spiritual care. CONCLUSIONS Additional support with spiritual care provision is needed, especially among spiritual care generalists. A focus on culturally attuned care is needed, honoring unique patient contexts and centering patient and family priorities.
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Affiliation(s)
- Megan Miller
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - William E Rosa
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Meghan McDarby
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Batzler YN, Stricker N, Bakus S, Schallenburger M, Schwartz J, Neukirchen M. Implementing spiritual care education into the teaching of palliative medicine: an outcome evaluation. BMC MEDICAL EDUCATION 2024; 24:411. [PMID: 38622620 PMCID: PMC11017578 DOI: 10.1186/s12909-024-05415-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 04/11/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The concept of "total pain" plays an important role in palliative care; it means that pain is not solely experienced on a physical level, but also within a psychological, social and spiritual dimension. Understanding what spirituality entails, however, is a challenge for health care professionals, as is screening for the spiritual needs of patients. OBJECTIVE This is a novel, interprofessional approach in teaching undergraduate medical students about spiritual care in the format of a seminar. The aim of this study is to assess if an increase in knowledge about spiritual care in the clinical context is achievable with this format. METHODS In a mandatory seminar within the palliative care curriculum at our university, both a physician and a hospital chaplain teach strategies in symptom control from different perspectives (somatic domain - spiritual domain). For evaluation purposes of the content taught on the spiritual domain, we conducted a questionnaire consisting of two parts: specific outcome evaluation making use of the comparative self-assessment (CSA) gain and overall perception of the seminar using Likert scale. RESULTS In total, 52 students participated. Regarding specific outcome evaluation, the greatest gain was achieved in the ability to define total pain (84.8%) and in realizing its relevance in clinical settings (77.4%). The lowest, but still fairly high improvement was achieved in the ability to identify patients who might benefit from spiritual counselling (60.9%). The learning benefits were all significant as confirmed by confidence intervals. Overall, students were satisfied with the structure of the seminar. The content was delivered clearly and comprehensibly reaching a mean score of 4.3 on Likert scale (4 = agree). The content was perceived as overall relevant to the later work in medicine (mean 4.3). Most students do not opt for a seminar solely revolving around spiritual care (mean 2.6). CONCLUSIONS We conclude that implementing spiritual care education following an interprofessional approach into existing medical curricula, e.g. palliative medicine, is feasible and well perceived among medical students. Students do not wish for a seminar which solely revolves around spiritual care but prefer a close link to clinical practice and strategies.
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Affiliation(s)
- Yann-Nicolas Batzler
- Interdisciplinary Center for Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - Nicola Stricker
- Evangelical Church in the Rhineland, Duesseldorf, Germany
- Institut Protestant de Théologie, Paris, France
| | - Simone Bakus
- Evangelical Hospital Chaplaincy (Pastoral Care), University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - Manuela Schallenburger
- Interdisciplinary Center for Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany.
- Interdisciplinary Centre for Palliative Medicine, Medical Faculty, Heinrich Heine University Duesseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Jacqueline Schwartz
- Interdisciplinary Center for Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - Martin Neukirchen
- Interdisciplinary Center for Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
- Department of Anesthesiology, University Hospital, Heinrich Heine University, Düsseldorf, Germany
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Jones KF, Washington J, Kearney M, Best MC. What is the role of spiritual care specialists in teaching generalist spiritual care? The perspectives of pastoral care staff in a large Catholic health and aged care organisation. J Health Care Chaplain 2023; 29:368-380. [PMID: 35788182 DOI: 10.1080/08854726.2022.2095779] [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: 10/17/2022]
Abstract
The value of spiritual care training for all staff working in health and aged care has been demonstrated. This study investigated how spiritual care specialists (SCSs) perceive their role in delivering spiritual care education to other staff. Fourteen SCSs participated in three online focus groups. Two key themes were identified: First, SCSs build upon existing capacity of staff by: (i) recognising existing strengths and capabilities; (ii) using relevant stories; (iii) using language which makes spiritual care accessible; (iv) making training relevant and practical; (v) tapping into staff vocation or calling; and (vi) building awareness of one's own spirituality. Second, SCSs assist staff to draw upon SCS expertise by establishing a trusting relationship and developing staff awareness of the SCS role. The SCS's role in delivering spiritual care education is an important one, and further consideration regarding how to support them in this role is warranted.
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Affiliation(s)
- Kate Fiona Jones
- Institute for Ethics and Society, University of Notre Dame Australia, Sydney, Australia
| | | | | | - Megan C Best
- Institute for Ethics and Society, University of Notre Dame Australia, Sydney, Australia
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Ehman JW, Edgar JR. Spirituality and Chaplaincy Supporting ICU Survivorship: A Practical Overview and Strategy for Clinicians. JOURNAL OF RELIGION AND HEALTH 2023; 62:65-82. [PMID: 36583768 DOI: 10.1007/s10943-022-01730-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
This overview of the current literature of spirituality and health and the role of professional chaplains specifically considers intensive care unit survivorship, instead of the more common focus on end-of-life circumstances or family support on an ICU. The purpose is to enhance clinicians' understanding and use of spiritual resources for patient care and outcomes. It is a product of comprehensive daily monitoring of the Medline database from 2002 to 2022 for all publications indexed by the terms "spiritual," "religion," and "chaplain." A case will be used throughout, to illustrate spirituality dynamics. Also, a practical strategy, developed by the authors from clinical experience, will be outlined for clinicians' spiritual support of patients, requiring little time or specialized knowledge and avoiding the blurring of professional roles and boundaries, while potentially yielding clinical benefits suggested in the medical literature.
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Affiliation(s)
- John W Ehman
- Department of Pastoral Care, Penn Presbyterian Medical Center, Chaplain's Office (CU1 206), 51 N. 39 St., Philadelphia, PA, 19104, USA.
| | - Joshua R Edgar
- Department of Pastoral Care, Penn Presbyterian Medical Center, Chaplain's Office (CU1 206), 51 N. 39 St., Philadelphia, PA, 19104, USA
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Miquel Diego P, Ciccorossi M, Ferrer Svoboda I. El desarrollo de la competencia espiritual en clínica. REVISTA IBEROAMERICANA DE BIOÉTICA 2022. [DOI: 10.14422/rib.i18.y2022.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
El cuidado de lo espiritual es un componente nuclear en la comprensión de los cuidados paliativos. Sin embargo, la integración asistencial de la espiritualidad en clínica es todavía un tema pendiente de resolver. Este estudio analiza el proceso de diseño y evaluación de un programa formativo de espiritualidad en clínica basado en las necesidades formativas de los profesionales dedicados a la atención paliativa pediátrica en España. El desarrollo de habilidades, actitudes y la adquisición de conocimientos sobre espiritualidad en el ámbito sanitario puede verse favorecido a través de una formación orientada a la práctica, situada culturalmente, bajo un marco teórico de consenso y con una perspectiva interdisciplinar.
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Szilagyi C, Lion AH, Varner Perez SE, Koch S, Oyedele O, Slaven JE, Montz K, Haase JE, Puchalski CM. Interprofessional spiritual care education in pediatric hematology-oncology: A pilot study. Pediatr Blood Cancer 2022; 69:e29515. [PMID: 34913577 DOI: 10.1002/pbc.29515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 11/12/2021] [Accepted: 11/20/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Evidence and clinical guidelines call care team members to address the spiritual well-being of pediatric patients, especially adolescents and young adults (AYA), with cancer and blood disorders. However, the lack of relevant training in generalist spiritual care has been a key barrier. Therefore, we aimed to improve clinicians' capabilities by utilizing the Interprofessional Spiritual Care Education Curriculum (ISPEC) to close this gap in pediatric hematology-oncology. A model of interprofessional spiritual care entails that all team members attend to patients' spirituality by employing generalist spiritual care skills and collaborating with spiritual care specialists such as chaplains. METHODS Interdisciplinary team members providing care for AYA with cancer and blood disorders were recruited to participate in interprofessional spiritual care education. Our intervention combined an evidence-based online curriculum and in-person discussion groups. Pretest-posttest study examined changes in participants' skills and practices to identify, address, and discuss spiritual concerns. Surveys were conducted at baseline and at 1, 3, and 6 months after the intervention. RESULTS Participants (n = 21) included physicians, advanced practice providers, nurse coordinators, and psychosocial team members. We observed positive changes in participants' ability (36%, P < 0.01), frequency (56%, P = 0.01), confidence (32%, P < 0.01), and comfort (31%, P = 0.02) providing generalist spiritual care baseline versus one month, with significant gains maintained through six months (Omnibus P < 0.05). CONCLUSIONS Utilizing ISPEC, interprofessional spiritual care education has a strong potential to develop pediatric hematology-oncology team members' capabilities to attend to the spiritual aspect of whole-person care and thus contribute to the well-being of AYA with cancer and blood disorders.
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Affiliation(s)
- Csaba Szilagyi
- Johns Hopkins Medicine, Baltimore, Maryland.,Faculty of Theological and Religious Studies, KU Leuven, Leuven, Belgium
| | - Alex H Lion
- Indiana University School of Medicine, Indianapolis, Indiana.,Daniel F. Evans Center for Spiritual and Religious Values in Healthcare at Indiana University Health, Indianapolis, Indiana
| | - Shelley E Varner Perez
- Daniel F. Evans Center for Spiritual and Religious Values in Healthcare at Indiana University Health, Indianapolis, Indiana.,Indiana University Health, Indianapolis, Indiana.,Regenstrief Institute, Inc., Indianapolis, Indiana
| | - Sarah Koch
- Indiana University Health, Indianapolis, Indiana
| | | | - James E Slaven
- Indiana University School of Medicine, Indianapolis, Indiana
| | - Kianna Montz
- Indiana University Health, Indianapolis, Indiana
| | - Joan E Haase
- Indiana University School of Nursing, Indianapolis, Indiana
| | - Christina M Puchalski
- George Washington University School of Medicine, Washington, District of Columbia.,The George Washington University Institute for Spirituality and Health (GWish), Washington, District of Columbia
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Jones KF, Paal P, Symons X, Best MC. The Content, Teaching Methods and Effectiveness of Spiritual Care Training for Healthcare Professionals: A Mixed-Methods Systematic Review. J Pain Symptom Manage 2021; 62:e261-e278. [PMID: 33757893 DOI: 10.1016/j.jpainsymman.2021.03.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023]
Abstract
CONTEXT Spirituality has been demonstrated to play an important role in healthcare, yet many staff feel ill-equipped to deliver spiritual care. Spiritual care training programs have been developed to address this need. OBJECTIVE The aim of this mixed-methods systematic review was to identify spiritual care training programs for healthcare professionals or students, and to investigate program content, teaching methods, key outcomes, and identified challenges and facilitators. METHODS A mixed-methods systematic review was conducted. The search terms ('religio*' OR 'spiritual*' OR 'existenti*') were combined with ('educat*' OR 'train*' OR 'curricul*' OR 'program*'), AND ('care' OR 'therap*' OR 'treatment' OR 'competenc*'). Search terms were entered into the following data bases: PsycINFO, Medline, Cinahl and Web of Science. Findings were restricted to peer-reviewed studies published in English between January 2010 and February 2020. RESULTS Fifty-five studies were identified. The quality of studies was mixed. Programs encompassed a range of content and teaching methods. Reported outcomes included increased levels of competency across intrapersonal spirituality, interpersonal spirituality, and spiritual assessment and interventions. Identified barriers included competing healthcare priorities, negative perceptions of spirituality and spiritual care, resistance towards focusing on one's own spirituality, staff feeling inadequate, and the need for ongoing training. Facilitators included opportunities for reflection, involvement of chaplains, application of practical tools, opportunities for practice, online training, and managerial support. CONCLUSIONS Positive outcomes following spiritual care training were identified. Further research is needed to identify patient-related outcomes of staff training, and to examine how the benefits of such training can be maintained over time.
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Affiliation(s)
- Kate Fiona Jones
- Institute for Ethics and Society, University of Notre Dame Australia; St Vincent's Hospital, Sydney, Australia.
| | - Piret Paal
- Institute for Nursing Science and Practice, Paracelsus Medical University, Austria
| | - Xavier Symons
- Institute for Ethics and Society, University of Notre Dame Australia; St Vincent's Hospital, Sydney, Australia; Plunkett Centre for Ethics, Australian Catholic University, Australia
| | - Megan C Best
- Institute for Ethics and Society, University of Notre Dame Australia; St Vincent's Hospital, Sydney, Australia
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8
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Puchalski C, Ferrell BR, Borneman T, DiFrances Remein C, Haythorn T, Jacobs C. Implementing quality improvement efforts in spiritual care: outcomes from the interprofessional spiritual care education curriculum. J Health Care Chaplain 2021; 28:431-442. [PMID: 34396929 DOI: 10.1080/08854726.2021.1917168] [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: 10/20/2022]
Abstract
The Interprofessional Spiritual Care Curriculum (ISPEC) was created to train interdisciplinary health care teams to recognize and address the spiritual needs of seriously or chronically ill patients. The curriculum, in a train-the-trainer format, employs didactic presentations, discussions, lab sessions, skill demonstrations, and video clips. In course applications, participants were required to submit goals to achieve and demonstrate institutional support. For the first ISPEC course, in July 2018, 48 clinician-chaplain teams attended. Following the 2½ day course, participants had access to online training modules for 1-year, ISPEC faculty mentoring support, and regular conference calls on goal implementation progress. Participants reported recognizing the importance of providing spiritual care and a new understanding of how collaborating as interprofessional teams enabled them to integrate this care into their home institution settings. In a mixed-methods evaluation survey completed 12 months after the ISPEC course, participants reported on the percentage of their goals completed, number and types of professionals they had educated in spiritual care, and personal confidence regarding spiritual care leadership skills. This data can serve as a model to guide other organizations striving to improve spiritual care, practiced collaboratively by clinicians and chaplains, as an essential aspect of overall QI efforts in palliative care.
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Affiliation(s)
- Christina Puchalski
- George Washington Institute for Spirituality and Health (GWish), Washington, DC, USA
| | - Betty R Ferrell
- Department of Nursing Research and Education, City of Hope Medical Center, Duarte, CA, USA
| | - Tami Borneman
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Medical Center, Duarte, CA, USA
| | | | - Trace Haythorn
- Association for Clinical Pastoral Education (ACPE), Atlanta, GA, USA
| | - Carolyn Jacobs
- Smith College School for Social Work, Northampton, MA, USA
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Kirchoff RW, Tata B, McHugh J, Kingsley T, Burton MC, Manning D, Lapid M, Chaudhary R. Spiritual Care of Inpatients Focusing on Outcomes and the Role of Chaplaincy Services: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2021; 60:1406-1422. [PMID: 33575891 DOI: 10.1007/s10943-021-01191-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/19/2021] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To identify demographic trends associated with patient utilization and healthcare provider request for spiritual care services and to describe the impact of spiritual care on the quality of life (QoL), spiritual well-being (SWB) and level of satisfaction (SAT) of hospitalized patients. PATIENTS AND METHODS A systematic search of Ovid MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, was combined with review of relevant bibliographies. A total of 464 titles and abstracts were reviewed. Data were independently extracted by reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on the effects of spiritual interventions on QoL, SWB and SAT were extracted, along with demographic data reflecting chaplain services. The results of the studies are presented narratively and in a qualitative manner. RESULTS Observational or experimental studies investigating chaplain utilization demographics (n = 12), patient satisfaction (n = 9) and QoL/SWB (n = 3) were included. Perceived severity of illness, average length of stay and older age were consistently found to be predictors of higher need for spiritual care. Receipt of spiritual care was correlated with increased patient and family satisfaction, independent of clinical outcome. Chaplain interventions were associated with improvement in perceived QoL and SWB. In spite of this, healthcare workers rarely attempt to explore the patient's or family's need for spiritual care, with the majority of chaplaincy consults occurring in the final day of the patient's life, potentially leading to a failure to meet the spiritual needs of non-terminal patients who have spiritual trauma related to their resolving illnesses. CONCLUSION Attention to the spiritual needs of hospitalized patients is an essential yet often overlooked aspect of patient care. Chaplains serve as spiritual care specialists whose services can enhance the hospital experience, improve patient satisfaction and help to bridge potential gaps between the patient and medical providers.
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Affiliation(s)
| | - Beba Tata
- Mayo Clinic, 200 1st St SW, Rochester, MN, 55902, USA
| | - Jack McHugh
- Mayo Clinic, 200 1st St SW, Rochester, MN, 55902, USA
| | | | | | | | - Maria Lapid
- Mayo Clinic, 200 1st St SW, Rochester, MN, 55902, USA
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Twelve Years of the Italian Program to Enhance Relational and Communication Skills (PERCS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020439. [PMID: 33429873 PMCID: PMC7826793 DOI: 10.3390/ijerph18020439] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/22/2020] [Accepted: 01/05/2021] [Indexed: 11/17/2022]
Abstract
To describe the experience of the Italian Program to Enhance Relations and Communication Skills (PERCS-Italy) for difficult healthcare conversations. PERCS-Italy has been offered in two different hospitals in Milan since 2008. Each workshop lasts 5 h, enrolls 10–15 interdisciplinary participants, and is organized around simulations and debriefing of two difficult conversations. Before and after the workshops, participants rate their preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Usefulness, quality, and recommendation of the program are also assessed. Descriptive statistics, t-tests, repeated-measures ANOVA, and Chi-square were performed. A total of 72 workshops have been offered, involving 830 interdisciplinary participants. Participants reported improvements in all the dimensions (p < 0.001) without differences across the two hospitals. Nurses and other professionals reported a greater improvement in preparation, communication skills, and confidence, compared to physicians and psychosocial professionals. Usefulness, quality, and recommendation of PERCS programs were highly rated, without differences by discipline. PERCS-Italy proved to be adaptable to different hospital settings, public and private. After the workshops, clinicians reported improvements in self-reported competencies when facing difficult conversations. PERCS-Italy’s sustainability is based on the flexible format combined with a solid learner-centered approach. Future directions include implementation of booster sessions to maintain learning and the assessment of behavioral changes.
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Puchalski C, Jafari N, Buller H, Haythorn T, Jacobs C, Ferrell B. Interprofessional Spiritual Care Education Curriculum: A Milestone toward the Provision of Spiritual Care. J Palliat Med 2020; 23:777-784. [DOI: 10.1089/jpm.2019.0375] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Christina Puchalski
- George Washington Institute for Spirituality and Health (GWish), George Washington University, Washington, DC, USA
| | - Najmeh Jafari
- George Washington Institute for Spirituality and Health (GWish), George Washington University, Washington, DC, USA
| | - Haley Buller
- City of Hope Medical Center, Duarte, California, USA
| | - Trace Haythorn
- The Association for Clinical Pastoral Education, Decatur, Georgia, USA
| | - Carolyn Jacobs
- Smith College School for Social Work, Northampton, Massachusetts, USA
| | - Betty Ferrell
- City of Hope Medical Center, Duarte, California, USA
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12
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Palmer Kelly E, Hyer M, Payne N, Pawlik TM. Does spiritual and religious orientation impact the clinical practice of healthcare providers? J Interprof Care 2020; 34:520-527. [DOI: 10.1080/13561820.2019.1709426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Madison Hyer
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Nicolette Payne
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Timothy M. Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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13
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Thiel MM, Luff D, Kerr EE, Robinson MR, Meyer EC. Health Care Professionals' Reflections on Their Learning as Spiritual Generalists and Integration Into Practice. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2020; 40:228-234. [PMID: 33284173 DOI: 10.1097/ceh.0000000000000318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Meeting spiritual needs of patients is an important aspect of quality health care, but continuing professional development and training to provide spiritual care remains inadequate. The purpose was to identify participants' learning from simulation-based spiritual generalist workshops and application to practice. METHODS Interdisciplinary participants completed self-report demographic questionnaires before the workshops and questionnaires after workshops that listed open-ended take-home learning. Responses were analyzed using qualitative content analysis. A subgroup was surveyed 3 to 9 months after training to examine whether and how participants had incorporated workshop learning into clinical work. RESULTS Workshop participants 181/211 (85.8%) reported learning in four categories: core values and skills of spiritual generalists, understanding spirituality/religion and its role in health care, interfacing with chaplaincy, and interprofessional teamwork. Of the subsample, 73.5% (25/34) completed surveys 3 to 9 months after training. Of those, 25/25 (100%) reported drawing on what they learned in workshops, and 24/25 (96%) reported making clinical practice changes. DISCUSSION One-day spiritual generalist simulation-based workshops can improve continuing professional development learning experiences to provide generalist level of spiritual care. Workshops offered valuable learning and resulted in applicable clinical skills across professional roles. At 3 to 9 months after training, participants reported improved spiritual screening, recognition of spiritual distress, and referral to chaplaincy.
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Affiliation(s)
- Mary Martha Thiel
- Ms. Thiel: Chaplain, Department of Spiritual Care, Hebrew SeniorLife, Roslindale, MA. Department of Anesthesia, Dr. Luff: Director of Curriculum Design and Quality, Boston Children's Hospital Simulator Program and Assistant Professor of Anesthesiology, Harvard Medical School, Boston Children's Hospital and Harvard Medical School, Landmark Center, Boston, MA. Ms. Kerr: Research Associate, Department of Preventive Medicine, Brigham and Women's Hospital, Boston, MA. Ms. Robinson: Retired Chaplain, Department of Chaplaincy, Boston Children's Hospital, Boston, MA. Dr. Meyer: Senior Attending Psychologist, Boston Children's Hospital and Associate Professor of Psychology, Harvard Medical School, Department of Psychiatry, Boston Children's Hospital, Center for Bioethics, Harvard Medical School, Boston, MA
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Bandini JI, Thiel MM, Meyer EC, Paasche-Orlow S, Zhang Q, Cadge W. Interprofessional Spiritual Care Training for Geriatric Care Providers. J Palliat Med 2019; 22:1236-1242. [DOI: 10.1089/jpm.2018.0616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Julia I. Bandini
- Department of Sociology, Brandeis University, Waltham, Massachusetts
| | - Mary Martha Thiel
- Clinical Pastoral Education, Hebrew SeniorLife, Boston, Massachusetts
| | - Elaine C. Meyer
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts
- Center for Bioethics, Harvard Medical School, Boston, Massachusetts
| | | | - Qian Zhang
- Heller School of Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Wendy Cadge
- Department of Sociology, Brandeis University, Waltham, Massachusetts
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15
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Shah S, Frey R, Shipman K, Gardiner F, Milne H. A survey to explore health care staff perceptions of spirituality and spiritual care working in a single district health area in New Zealand. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
PURPOSE OF REVIEW There is increasing emphasis on medical care of the whole patient. This holistic approach encompasses supporting the spiritual or religious needs of the patient. Particularly at the end of life, spiritual concerns may come to the fore as patients recognize and accept their impending death. Physicians may also recognize this spiritual distress but may not be clear on how to provide spiritual support. RECENT FINDINGS Tools to screen for spiritual concerns are available for physicians to use. Some physicians wish to go further, supporting patients at the end of life in their spiritual quest. Other physicians express concern about causing more distress to patients in a time of significant need. Descriptions of educational tools, as well as the difference between spiritual generalists and spiritual specialists have emerged. Integration of chaplains into the medical team caring for patients at the end of life will also enhance care of the whole patient. SUMMARY The increasing emphasis on whole patient care is leading to increasing focus on spiritual concerns of patients. Although not every patient has an interest in spiritual conversation, most do and medical teams will need to become more educated about appropriate spiritual engagement.
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Abstract
PURPOSE OF REVIEW Heart failure is an illness with high morbidity and mortality that affects 5.7 million Americans. As advanced heart therapies become more prevalent care for patients and families is becoming more complex. The American Heart Association has released a policy statement recommending continuous, high-quality access to palliative care for all patients with heart failure, and the Center for Medicare Services requires palliative care involvement in mechanical circulatory support teams. RECENT FINDINGS The National Quality Forum developed eight domains of palliative care that are required for high-quality delivery of comprehensive palliative care. This article assesses each domain and how it pertains to evolving care of patients with advanced heart failure. Leadership from heart failure teams should review the domains of palliative care to ensure they are improving primary palliative care skills as well as identifying areas needed to improve funding so that patients have access to comprehensive specialty level palliative care.
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Affiliation(s)
- Todd Barrett
- Ohio State University Ross Heart Hospital, McCampbell Hall, 5th Floor, 1581 Dodd Drive, Columbus, OH, 43210, USA.
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Abdollahpour S, Khosravi A. Relationship between Spiritual Intelligence with Happiness and Fear of Childbirth in Iranian Pregnant Women. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:45-50. [PMID: 29344046 PMCID: PMC5769185 DOI: 10.4103/ijnmr.ijnmr_39_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: Spiritual intelligence is a person's ability to feel a connection to a higher power and a sacred entity. With regard to its relation with happiness, it can have an important effect on the mental health of pregnant women. Therefore, this study aimed to investigate the relationship between spiritual intelligence and happiness and fear of childbirth in pregnant women. Materials and Methods: This cross-sectional study was conducted on 245 low-risk pregnant women from June till September 2015. Using random cluster sampling method, the subjects were selected among the women who referred to health care centers in Shahroud (Northeast of Iran). After obtaining informed consent, the researchers evaluated the spiritual intelligence, happiness, and fear of childbirth. Data were analyzed using STATA12 and Chi-square test, t-test, analysis of variance, and Strucrural Equation Model. Results: In this study, the spiritual intelligence mean (SD) score was 64.43(16.51). Comparison between mothers with and without fear of childbirth showed there was a significant difference between the spiritual intelligence score and happiness mean scores in these two groups. There is a negative correlation between spiritual intelligence and happiness with fear of childbirth (−0.73 and −0.69, respectively). Conclusions: Increased level of spiritual intelligence in pregnant women can lead to an increase in their happiness and reduce their fear of childbirth. The fear of childbirth can be prevented via trainings to pregnant women about the components of spiritual intelligence; moreover, training the techniques to achieve more happiness can help mothers to reduce their fear of childbirth and hence promote natural childbirth.
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Affiliation(s)
- Sedigheh Abdollahpour
- Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Ahmad Khosravi
- Center or Health Related Social and Behavioral Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
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Barello S, Graffigna G, Pitacco G, Mislej M, Cortale M, Provenzi L. An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study. Front Psychol 2017; 7:2020. [PMID: 28119644 PMCID: PMC5222845 DOI: 10.3389/fpsyg.2016.02020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/12/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction: Growing evidence recognizes that patients who are motivated to take an active role in their care can experience a range of health benefits and reduced healthcare costs. Nurses play a critical role in the effort to make patients fully engaged in their disease management. Trainings devoted to increase nurses' skills and knowledge to assess and promote patient engagement are today a medical education priority. To address this goal, we developed a program of nurse education training in patient engagement strategies (NET-PES). This paper presents pilot feasibility study and preliminary participants outcomes for NET-PES. Methods: This is a pilot feasibility study of a 2-session program on patient engagement designed to improve professional nurses' ability to engage chronic patients in their medical journey; the training mainly focused on passing patient engagement assessment skills to clinicians as a crucial mean to improve care experience. A pre-post pilot evaluation of NET-PES included 46 nurses working with chronic conditions. A course specific competence test has been developed and validated to measure patient engagement skills. The design included self-report questionnaire completed before and after the training for evaluation purposes. Participants met in a large group for didactic presentations and then they were split into small groups in which they used role-play and case discussion to reflect upon the value of patient engagement measurement in relation to difficult cases from own practice. Results: Forty-six nurses participated in the training program. The satisfaction questionnaire showed that the program met the educational objectives and was considered to be useful and relevant by the participants. Results demonstrated changes on clinicians' attitudes and skills in promoting engagement. Moreover, practitioners demonstrated increases on confidence regarding their ability to support their patients' engagement in the care process. Conclusions: Learning programs teaching nurses about patient engagement strategies and assessment measures in clinical practice are key in supporting the realization of patient engagement in healthcare. Training nurses in this area is feasible and accepted and might have an impact on their ability to engage patients in the chronic care journey. Due to the limitation of the research design, further research is needed to assess the effectiveness of such a program and to verify if the benefits envisaged in this pilot are maintained on a long-term perspective and to test results by employing a randomized control study design.
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Affiliation(s)
- Serena Barello
- Department of Psychology, Università Cattolica del Sacro CuoreMilan, Italy
| | | | - Giuliana Pitacco
- Azienda Sanitaria Universitaria Integrata di TriesteTrieste, Italy
| | - Maila Mislej
- Azienda Sanitaria Universitaria Integrata di TriesteTrieste, Italy
| | - Maurizio Cortale
- Azienda Sanitaria Universitaria Integrata di TriesteTrieste, Italy
| | - Livio Provenzi
- 0-3 Center for the at-Risk Infant - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Eugenio MedeaBosisio Parini, Italy
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Affiliation(s)
- Stacy M Fischer
- General Internal Medicine, University of Colorado Denver , Aurora, Colorado
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