1
|
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.
Collapse
Affiliation(s)
| | | | | | | | | | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
2
|
Galchutt PK. Spiritual assessment models for palliative care chaplains: a narrative review. J Health Care Chaplain 2024:1-17. [PMID: 38900925 DOI: 10.1080/08854726.2024.2368999] [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: 06/22/2024]
Abstract
Palliative care chaplains conduct spiritual assessments for those within their care. This narrative review examined the literature concerning existing spiritual assessment models developed or designated for palliative care chaplain use. The literature review was performed using four databases, including a hand search of references due to the variability of keywords used within the spiritual care literature. Five spiritual assessment models were identified. The analysis of the models focused on three areas: (1) Foundational basis, (2) Spiritual needs, and (3) Structural frameworks. Published spiritual assessment models for palliative care chaplain use are variable in how each one was formed, how each tool describes and structures spiritual care needs, and how the models are implemented within their respective contexts. The PC-7 advances the field, especially through its mixed methods approach. Future validation and reliability research is needed as well as investigations concerning which models are taught by chaplain educators and used by palliative care chaplains.
Collapse
Affiliation(s)
- Paul K Galchutt
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA
- Department of Pharmacy Practice and Science, University of Maryland, Baltimore, MD, USA
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
La IS, Johantgen M, Storr CL, Zhu S, Cagle JG, Ross A. Spirituality moderates the relationship between cancer caregiver burden and depression. Palliat Support Care 2024; 22:470-481. [PMID: 38131143 DOI: 10.1017/s1478951523001785] [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: 12/23/2023]
Abstract
OBJECTIVES Cancer has become a chronic disease that requires a considerable amount of informal caregiving, often quite burdensome to family caregivers. However, the influence of spirituality on the caregivers' burden and mental health outcomes has been understudied. This study was to examine how caregiver burden, spirituality, and depression change during cancer treatment and investigate the moderating role of spirituality in the relationship between caregiver burden and depression for a sample of caregivers of persons with cancer. METHODS This secondary analysis used a longitudinal design employing 3 waves of data collection (at baseline, 3 months, and 6 months). Family caregivers completed the Caregiver Reaction Assessment, Spiritual Perspective Scale, and the PROMIS® depression measure. Linear mixed model analyses were used, controlling for pertinent covariates. RESULTS Spirituality, total caregiver burden, and depression remained stable over 6 months. More than 30% of the caregivers had mild to severe depressive symptoms at 3 time points. There was evidence of overall burden influencing depression. Of note was a protective effect of caregivers' spirituality on the relationship between depression and caregiver burden over time (b = -1.35, p = .015). The lower the spirituality, the stronger the relationship between depression and burden, especially regarding subscales of schedule burden, financial burden, and lack of family support. SIGNIFICANCE OF RESULTS Spirituality was a significant resource for coping with caregiving challenges. This study suggests that comprehensive screening and spiritual care for cancer caregivers may improve their cancer caregiving experience and possibly influence the care recipients' health.
Collapse
Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Alyson Ross
- Wisdom of the Whole Coaching Academy, Asheville, NC, USA
| |
Collapse
|
5
|
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.
Collapse
|
6
|
Cheng L, Chen H, Lin L, Li H, Zhang F. Spiritual needs of older adults with cancer: A modified concept analysis. Asia Pac J Oncol Nurs 2023; 10:100288. [PMID: 38023729 PMCID: PMC10661515 DOI: 10.1016/j.apjon.2023.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/01/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To clarify the concept of spiritual needs and explain its meaning to older adults with cancer. Methods Electronic databases (Web of Science, PubMed, EBSCOASU, CNKI, Wanfang, and VIP) were systematically searched and analyzed using "spiritual needs" as keywords. Rodgers' evolutionary method guided the concept analysis to identify attributes, antecedents, and consequences. Two rounds of Delphi expert consultations ensured accuracy, reliability, and feasibility for implementation. Results Spiritual needs express an individual's expectations of comfort and inner peace that satisfy his or her perception of the meaning and purpose of life, the ability to love and be loved, feelings of peace and gratitude, and a sense of belonging and hope. Spiritual needs have four dimensions: personal, communal, environmental, and transcendence or supreme. The attributes of spiritual needs include meaning and purpose of life, love and being loved, peace and gratitude, belonging, and hope. The antecedents include spiritual recognition and events that trigger spiritual needs and spiritual need thresholds. The outcomes of addressing and meeting the spiritual needs of older adults with cancer include promoting their spiritual health and enhancing their quality of life. After two rounds of Delphi experts' consultation, the expert authority coefficients (Cr) were 0.83 and 0.88, respectively. Experts agreed on the concept of spiritual needs. Conclusions Exploring antecedents of spiritual needs in older adults with cancer clarifies obstacles to spiritual practice, offering intervention strategies for spiritual care and well-being. Meeting their spiritual needs enhances spiritual health and quality of life, essential in humanistic nursing care.
Collapse
Affiliation(s)
- Linan Cheng
- School of Nursing, Soochow University, Suzhou, China
| | - Hongxiu Chen
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Lu Lin
- School of Nursing, Soochow University, Suzhou, China
| | - Huiling Li
- School of Nursing, Soochow University, Suzhou, China
| | - Fengying Zhang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| |
Collapse
|
7
|
Teteh DK, Ferrell B, Okunowo O, Downie A, Erhunmwunsee L, Montgomery SB, Raz D, Kittles R, Kim JY, Sun V. Social determinants of health and lung cancer surgery: a qualitative study. Front Public Health 2023; 11:1285419. [PMID: 38026333 PMCID: PMC10644827 DOI: 10.3389/fpubh.2023.1285419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Social determinants of health (SDOH) are non-clinical factors that may affect the outcomes of cancer patients. The purpose of this study was to describe the influence of SDOH factors on quality of life (QOL)-related outcomes for lung cancer surgery patients. Methods Thirteen patients enrolled in a randomized trial of a dyadic self-management intervention were invited and agreed to participate in semi-structured key informant interviews at study completion (3 months post-discharge). A conventional content analysis approach was used to identify codes and themes that were derived from the interviews. Independent investigators coded the qualitative data, which were subsequently confirmed by a second group of independent investigators. Themes were finalized, and discrepancies were reviewed and resolved. Results Six themes, each with several subthemes, emerged. Overall, most participants were knowledgeable about the concept of SDOH and perceived that provider awareness of SDOH information was important for the delivery of comprehensive care in surgery. Some participants described financial challenges during treatment that were exacerbated by their cancer diagnosis and resulted in stress and poor QOL. The perceived impact of education varied and included its importance in navigating the healthcare system, decision-making on health behaviors, and more economic mobility opportunities. Some participants experienced barriers to accessing healthcare due to insurance coverage, travel burden, and the fear of losing quality insurance coverage due to retirement. Neighborhood and built environment factors such as safety, air quality, access to green space, and other environmental factors were perceived as important to QOL. Social support through families/friends and spiritual/religious communities was perceived as important to postoperative recovery. Discussion Among lung cancer surgery patients, SDOH factors can impact QOL and the patient's survivorship journey. Importantly, SDOH should be assessed routinely to identify patients with unmet needs across the five domains. SDOH-driven interventions are needed to address these unmet needs and to improve the QOL and quality of care for lung cancer surgery patients.
Collapse
Affiliation(s)
- Dede K. Teteh
- Department of Health Sciences, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA, United States
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Oluwatimilehin Okunowo
- Division of Biostatistics, Department of Computational and Quantitative Medicine, Beckman Research Institute of City of Hope, Duarte, CA, United States
| | - Aidea Downie
- School of Public Health, Brown University, Providence, RI, United States
| | - Loretta Erhunmwunsee
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | | | - Dan Raz
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Rick Kittles
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, United States
| | - Jae Y. Kim
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
- Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| |
Collapse
|