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Rangel T, Weisbrich G, Sumner S, Gaines A, Leavitt R. Factors associated with health personnel-chaplain interactions in the hospital setting: a cross-sectional survey study. J Health Care Chaplain 2024:1-15. [PMID: 39224946 DOI: 10.1080/08854726.2024.2393551] [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: 09/04/2024]
Abstract
Health personnel may seek chaplain support to discuss stressors related to complex patient cases, difficult team dynamics, and personal issues. In this survey study of 1376 healthcare interprofessional clinicians, participants reported interacting with chaplains most frequently over patient-related stressors in the prior 12 months. Factors associated with chaplain interactions to discuss all three stressors included: reporting chaplains provide spiritual support to health personnel, more years of service, seeking professional help to deal with stressors, and higher levels of secondary traumatic stress. Being a registered nurse (RN) and working in a critical care specialty were associated with increased odds of interactions with a chaplain to discuss patient-related stressors while identifying as Catholic or Protestant was associated with chaplain interactions to discuss team-related and personal stressors. Chaplains should tailor interventions to promote health personnel's spiritual well-being based on patient-related, team-related, and personal stressors. Healthcare institutions which do not employ chaplains should advocate for this resource. Leaders in healthcare settings with chaplains should promote increased staff awareness that chaplains are available to support wellbeing by discussing patient, team, or personal stressors.
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Affiliation(s)
- Teresa Rangel
- Clinical Excellence, Research, and Practice, Providence Central Division, Spokane, WA, USA
| | - Gary Weisbrich
- Spiritual Care, Providence St. Patrick Hospital, Missoula, MT, USA
| | - Sarah Sumner
- Intensive Care Unit, Providence Saint Joseph Medical Center, Burbank, CA, USA
| | - Adam Gaines
- Spiritual Care, Providence Sacred Heart Medical Center, Spokane, WA, USA
| | - Robert Leavitt
- Palliative Care, Providence Sacred Heart Medical Center, Spokane, WA, USA
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2
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Burlar A, Conroy S. An Exploration of the Supportive Care Needs of Caribbean Families of Critically Ill Adults. J Christ Nurs 2024; 41:E40-E46. [PMID: 38853326 DOI: 10.1097/cnj.0000000000001182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
ABSTRACT Nurses care for patients of diverse cultures. Persons in and from the Caribbean region have specific needs and concerns related to the support they need when a family member is admitted to an intensive care unit (ICU). Nurses familiar with Caribbean patient culture can provide these family members with knowledgeable and culturally competent care. However, little research exists about the unique needs of this population. This pilot study explored the nursing support needs of adult Caribbean family members of patients in the ICU.
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Brannon KJ, Felix ZP, Meyers KR, Stamey HM, Spilman SK. Nursing and Chaplain Partnership for Pain Management: A Survey of Nurses. Pain Manag Nurs 2024:S1524-9042(24)00184-X. [PMID: 38906727 DOI: 10.1016/j.pmn.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/08/2024] [Accepted: 05/19/2024] [Indexed: 06/23/2024]
Abstract
PURPOSE Pain is a universal experience for hospitalized patients, with physical, psychological, spiritual, and cognitive implications. As hospitals seek to identify nonpharmaceutical options for managing acute pain, the role of chaplains has been overlooked. The purpose of this study was to evaluate the perceptions of nurses regarding chaplain involvement in pain management. METHODS A survey was distributed to nurses to determine if they would request spiritual care services in various patient and family scenarios. Respondents were dichotomized into two groups based on self-report of whether they would contact a chaplain for patients with uncontrolled pain. Differences between groups were calculated using chi-square tests. RESULTS Of 45 nurse respondents, 27 (60%) reported they would not contact a chaplain for patients with uncontrolled pain. Nurses who would consult the chaplain for pain management did not differ from nurses who would not consult the chaplain in terms of their own religious identification, knowledge of patient religious documentation in the medical record, or past experience with chaplain services. CONCLUSIONS Study findings suggest that nurses' perceptions of chaplain involvement in pain management must be addressed prior to implementing a new hospital pain management protocol. CLINICAL IMPLICATIONS When developing and implementing new pain protocols based on holistic care of patients, hospitals should ensure that nursing staff are educated on when and how to incorporate chaplains as part of a holistic approach to managing acute pain.
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Dural G. Spiritual care experiences of nurses working in intensive care units: A qualitative study. Nurs Crit Care 2024; 29:545-554. [PMID: 37667443 DOI: 10.1111/nicc.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Most nurses working in intensive care units are unprepared to provide spiritual care to patients and they lack the competence and skills to provide spiritual care. Lack of moral evaluation of patients has negative effects on the patient. Spiritual care given to patients has effects on patient-nurse communication, general condition of the patient, and the quality of care. AIM This study was conducted to find out the spiritual care experiences of nurses working in intensive care units. STUDY DESIGN A qualitative descriptive design was used. The study was carried out with 14 nurses who were working in the intensive care units of a university hospital in eastern Turkey between May and July 2022. Two forms were created by the researcher according to the purpose of the study and the population. Inductive thematic analysis was used to evaluate the data. Ethics committee approval was obtained. RESULTS Ten of the nurses were women. Their ages were between 25 and 47 years, their working years ranged between 2 and 28 years, and their weekly working hours ranged between 40 to 56 hours. As a result of the thematic analysis, six themes and 18 sub-themes were determined: The themes determined are (1) Definition of spiritual care (2) Time of spiritual care, (3) Benefits of spiritual care, (4) Spiritual care practices, (5) Obstacles in providing spiritual care. CONCLUSIONS Providing spiritual care to patients in intensive care is a very important experience for nurses. Understanding spiritual care, recognizing its importance, and including it in nursing practice have a central significance. RELEVANCE TO CLINICAL PRACTICE Spiritual care provided in nursing profession is as important as physical care, and supporting patients in intensive care is at the heart of providing the best holistic care.
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Affiliation(s)
- Gül Dural
- Health Science Faculty, Internal Medicine Nursing Department, Fırat University, Elazığ, Turkey
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Bloomer MJ, Ranse K, Adams L, Brooks L, Coventry A. "Time and life is fragile": An integrative review of nurses' experiences after patient death in adult critical care. Aust Crit Care 2023; 36:872-888. [PMID: 36371292 DOI: 10.1016/j.aucc.2022.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Providing bereavement support and care to families is an aspect of critical care nursing practice that can be rewarding, yet emotionally and psychologically challenging. Whilst significant research has focused on end-of-life care in critical care, less is known about nurses' experiences after patient death. AIM The aim of this study was to synthesise research evidence on the experience of registered nurses after patient death in adult critical care. DESIGN A structured integrative review of the empirical literature was undertaken. A combination of keywords, synonyms, and Medical Subject Headings were used across the Cumulative Index Nursing and Allied Health Literature (CINAHL) Complete, Ovid Medline, PsycInfo, Embase, and Emcare databases. Records were independently assessed against inclusion and exclusion criteria. A process of forward and backward chaining was used to identify additional papers. All papers were assessed for quality. Narrative synthesis was used to analyse and present the findings. RESULTS From the 4643 records eligible for screening, 36 papers reporting 35 studies were included in this review, representing the voices of 1687 nurses from more than 20 countries. Narrative synthesis revealed three themes: (i) postmortem care, which encompassed demonstrating respect and dignity for the deceased, preparation of the deceased, and the concurrent death rituals performed by nurses; (ii) critical care nurses' support of bereaved families, including families of potential organ donors and the system pressures that impeded family support; and (iii) nurses' emotional response to patient death including coping mechanisms. CONCLUSIONS Whilst a focus on the provision of high-quality end-of-life care should always remain a priority in critical care nursing, recognising the importance of after-death care for the patient, family and self is equally important. Acknowledging their experience, access to formal education and experiential learning and formal and informal supports to aid self-care are imperative.
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Affiliation(s)
- Melissa J Bloomer
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia; Intensive Care Unit, Princess Alexandra Hospital, Metro South Health, Queensland Health, Queensland, Australia.
| | - Kristen Ranse
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia
| | - Leah Adams
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; Intensive Care Unit, Latrobe Regional Hospital, Victoria, Australia
| | - Laura Brooks
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; School of Nursing and Midwifery, Deakin University, Victoria, Australia; Centre for Quality and Patient Safety Research, Deakin University, Victoria, Australia
| | - Alysia Coventry
- End of Life Advisory Panel, Australian College of Critical Care Nurses, Victoria, Australia; St Vincent's Health Network Sydney, St Vincent's Hospital, Melbourne and Australian Catholic University, Australia
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Fowler EK. Assessing how Spirituality Affects Resiliency in the Pediatric Healthcare Practitioner. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2023; 77:34-40. [PMID: 36184950 DOI: 10.1177/15423050221127210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A literature review was conducted to examine the role of spirituality with resiliency in the pediatric workplace. Two themes emerged from the literature review: healthcare practitioners desire to have a sense of belonging at work and the utilization of chaplains is helpful. This study aims to discover how practitioners experience spiritual health in the workplace and identify interventions that enhance resiliency with the challenges of pediatrics. Implications from this study are applied to chaplaincy and research.
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Affiliation(s)
- Emily K Fowler
- Department of Spiritual Care, Stony Brook Medicine, Stony Brook, NY, USA
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Mascio R, Best M, Lynch S, Phillips J, Jones K. Factors influencing nurse spiritual care practices at the end of life: A systematic review. Palliat Support Care 2022; 20:878-896. [PMID: 34872626 DOI: 10.1017/s1478951521001851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim was to identify determinants of nurse spiritual/existential care practices toward end-of-life patients. Nurses can play a significant role in providing spiritual/existential care, but they actually provide this care less frequently than desired by patients. METHODS A systematic search was performed for peer-reviewed articles that reported factors that influenced nurses' spiritual/existential care practices toward adult end-of-life patients. RESULTS The review identified 42 studies and included the views of 4,712 nurses across a range of hospital and community settings. The most frequently reported factors/domains that influenced nurse practice were patient-related social influence, skills, social/professional role and identity, intentions and goals, and environmental context and resources. SIGNIFICANCE OF RESULTS A range of personal, organizational, and patient-related factors influence nurse provision of spiritual/existential care to end-of-life patients. This complete list of factors can be used to gauge a unit's conduciveness to nurse provision of spiritual/existential care and can be used as inputs to nurse competency frameworks.
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Affiliation(s)
- Rita Mascio
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW, Australia
| | - Megan Best
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW, Australia
| | - Sandra Lynch
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW, Australia
| | - Jane Phillips
- School of Nursing, University of Queensland, Brisbane, Queensland, Australia
| | - Kate Jones
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW, Australia
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Shannon C, Dwyre C, Grafton K. Faith Community Nurses Key to Promoting Health in At-Risk Communities: An Integrative Review. J Christ Nurs 2022; 39:228-235. [PMID: 36048595 DOI: 10.1097/cnj.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT An integrative literature review was conducted to identify recommendations to implement culturally congruent and spiritually connected approaches to health promotion in at-risk faith communities. Five themes emerged from an analysis of 48 articles meeting criteria for the review. Review results repeatedly highlighted the impact nurses-more specifically faith community nurses (FCNs)-can have on at-risk population outcomes and bridging the gap between minority communities and the healthcare establishment. Five recommended action steps provide program guidance to FCNs for promoting faith-based health in at-risk minority communities.
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Murgia C, Notarnicola I, Caruso R, De Maria M, Rocco G, Stievano A. Spirituality and Religious Diversity in Nursing: A Scoping Review. Healthcare (Basel) 2022; 10:1661. [PMID: 36141273 PMCID: PMC9498726 DOI: 10.3390/healthcare10091661] [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: 07/02/2022] [Revised: 08/20/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Spirituality is a common theme in the field of healthcare research. This study aimed to examine nurses' perceptions of spirituality in the context of the religious diversity of patients in pluri-religious settings. We performed a scoping review following the methodology on studies conducted between 2010 and 2020. We searched the following databases: CINAHL Plus, PubMed, and PsycINFO. For the identification of grey literature, the OpenGrey database was used. In total, 789 articles were reviewed. Of these, 16 met predetermined inclusion criteria. Two main overarching themes emerged from our inductive analysis: (a) the intertwining of spirituality and spiritual care in diverse religious landscapes and (b) obstacles impeding the inclusion of spiritual care in pluri-religious settings. According to our results, nurses consider that spirituality is interconnected with spiritual care for individuals from different religious backgrounds. Interpretations of spirituality in nursing practice vary widely, with spirituality and religiosity often shaped and influenced by culture and the experience of the professionals. Nurses attribute various meanings to spiritual care, most of which center on respecting personal, interpersonal, and relational aspects of religious and cultural beliefs and practices. Lack of education and specific skills, insufficient time, role ambiguity, and different religious beliefs were identified as hurdles to spiritual care. A poor work environment, a lack of patient privacy, including personal space, and a lack of compassion were also reported as deterrents to spiritual healing. More knowledge and training on different religions and spirituality are required to meet patients' spiritual needs to better overcome these hurdles.
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Affiliation(s)
- Carla Murgia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | | | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Italy
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship, OPI, 00133 Rome, Italy
| | - Alessandro Stievano
- Department of Experimental and Clinical Medicine, University of Messina, 98125 Messina, Italy
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Arad M, Alilu L, Habibzadeh H, Khalkhali H, Goli R. Effect of spiritual intelligence training on nurses' skills for communicating with patients - an experimental study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:127. [PMID: 35677273 PMCID: PMC9170219 DOI: 10.4103/jehp.jehp_1483_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 07/31/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Since poor communication with the patient has a negative impact on the quality of nursing care, taking the necessary measures to strengthen the relationship with the patient seems necessary. This study was conducted to determine the effect of spiritual intelligence training on nurses' skills for communicating with patients. MATERIALS AND METHODS This experimental study with the control group and the pretest-posttest design was conducted on 70 nurses working in Imam Khomeini Hospital, Mahabad, in 2019. Randomized stratified sampling was used to recruit participants. Then, participants were randomly assigned to the two groups of control and intervention. The demographic information form and the patient-nurse communication skill questionnaire were used to collect the data. For the intervention group, 7 spiritual intelligence training sessions were held as a workshop in 2 months. Two weeks and a month after the intervention, both groups completed the questionnaires. Data were analyzed with the SPSS software version 17.0. RESULTS The findings showed that the mean communication skill scores in the intervention group before training were 44.71 ± 7.62, which significantly increased to 66.22 ± 8.43 2 weeks after training. Bonferroni multiple comparisons showed the mean communication skill scores significantly increased before, 2 weeks later and in the follow-up phase in the intervention group (P < 0.001). CONCLUSION Spiritual intelligence training is effective in improving the communication skills of nurses. It is recommended that the prepared content can be provided to in-service training units; consequently, nurses can improve their communication skills by individual and group learning.
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Affiliation(s)
- Mansour Arad
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Leyla Alilu
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Hosein Habibzadeh
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Hamidreza Khalkhali
- Department of Biostatistics and Epidemiology, Inpatient's Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Rasoul Goli
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Badanta B, Rivilla-García E, Lucchetti G, de Diego-Cordero R. The influence of spirituality and religion on critical care nursing: An integrative review. Nurs Crit Care 2021; 27:348-366. [PMID: 33966310 DOI: 10.1111/nicc.12645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/21/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spiritual care could help family members and critically ill patients to cope with anxiety, stress and depression. However, health care professionals are poorly prepared and health managers are not allocating all the resources needed. AIMS AND OBJECTIVES To critically review the empirical evidence concerning the influence of spirituality and religion (S-R) on critical care nursing. METHODS An integrative review of the literature published in the last 10 years (2010-2019) was conducted in PubMed, Scopus, CINHAL, PsycINFO, Web of Science, Cochrane and LILACS. In addition, searches were performed in the System for Information on Grey Literature in Europe and the Grey Literature Report. Quantitative and/or qualitative studies, assessing S-R and including health care professionals caring for critically ill patients (i.e. adults or children), were included. RESULTS Forty articles were included in the final analysis (20 qualitative, 19 quantitative and 1 with a mixed methodology). The studies embraced the following themes: S-R importance and the use of coping among critical care patients and families; spiritual needs of patients and families; health care professionals' awareness of spiritual needs; ways to address spiritual care in the intensive care unit (ICU); definition of S-R by health care professionals; perceptions and barriers of addressing spiritual needs; and influence of S-R on health care professionals' outcomes and decisions. Our results indicate that patients and their families use S-R coping strategies to alleviate stressful situations in the ICU and that respecting patients' spiritual beliefs is an essential component of critical care. Although nurses consider spiritual care to be very important, they do not feel prepared to address S-R and report lack of time as the main barrier. CONCLUSION AND IMPLICATIONS FOR PRACTICE Critical care professionals should be aware about the needs of their patients and should be trained to handle S-R in clinical practice. Nurses are encouraged to increase their knowledge and awareness towards spiritual issues.
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Affiliation(s)
- Bárbara Badanta
- Research Group under the Andalusian Research CTS 1050 "Complex Care, Chronic and Health Outcomes", Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, University of Seville, Seville, Spain
| | | | - Giancarlo Lucchetti
- Department of Medicine, School of Medicine, Federal University of Juiz de Fora, Brazil
| | - Rocío de Diego-Cordero
- Research Group CTS 969 "Innovation in HealthCare and Social Determinants of Health", School of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
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Cook DJ, Takaoka A, Hoad N, Swinton M, Clarke FJ, Rudkowski JC, Heels-Ansdell D, Boyle A, Toledo F, Dennis BB, Fiest K, Vanstone M. Clinician Perspectives on Caring for Dying Patients During the Pandemic : A Mixed-Methods Study. Ann Intern Med 2021; 174:493-500. [PMID: 33284683 PMCID: PMC7747669 DOI: 10.7326/m20-6943] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has affected the hospital experience for patients, visitors, and staff. OBJECTIVE To understand clinician perspectives on adaptations to end-of-life care for dying patients and their families during the pandemic. DESIGN Mixed-methods embedded study. (ClinicalTrials.gov: NCT04602520). SETTING 3 acute care medical units in a tertiary care hospital from 16 March to 1 July 2020. PARTICIPANTS 45 dying patients, 45 family members, and 45 clinicians. INTERVENTION During the pandemic, clinicians continued an existing practice of collating personal information about dying patients and "what matters most," eliciting wishes, and implementing acts of compassion. MEASUREMENTS Themes from semistructured clinician interviews that were summarized with representative quotations. RESULTS Many barriers to end-of-life care arose because of infection control practices that mandated visiting restrictions and personal protective equipment, with attendant practical and psychological consequences. During hospitalization, family visits inside or outside the patient's room were possible for 36 patients (80.0%); 13 patients (28.9%) had virtual visits with a relative or friend. At the time of death, 20 patients (44.4%) had a family member at the bedside. Clinicians endeavored to prevent unmarked deaths by adopting advocacy roles to "fill the gap" of absent family and by initiating new and established ways to connect patients and relatives. LIMITATION Absence of clinician symptom or wellness metrics; a single-center design. CONCLUSION Clinicians expressed their humanity through several intentional practices to preserve personalized, compassionate end-of-life care for dying hospitalized patients during the SARS-CoV-2 pandemic. PRIMARY FUNDING SOURCE Canadian Institutes of Health Research and Canadian Critical Care Trials Group Research Coordinator Fund.
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Affiliation(s)
- Deborah J Cook
- McMaster University and St. Joseph's Healthcare, Hamilton, Ontario, Canada (D.J.C., J.C.R., A.B.)
| | - Alyson Takaoka
- McMaster University, Hamilton, Ontario, Canada (A.T., M.S., F.J.C., D.H., B.B.D., M.V.)
| | - Neala Hoad
- St. Joseph's Healthcare, Hamilton, Ontario, Canada (N.H., F.T.)
| | - Marilyn Swinton
- McMaster University, Hamilton, Ontario, Canada (A.T., M.S., F.J.C., D.H., B.B.D., M.V.)
| | - France J Clarke
- McMaster University, Hamilton, Ontario, Canada (A.T., M.S., F.J.C., D.H., B.B.D., M.V.)
| | - Jill C Rudkowski
- McMaster University and St. Joseph's Healthcare, Hamilton, Ontario, Canada (D.J.C., J.C.R., A.B.)
| | - Diane Heels-Ansdell
- McMaster University, Hamilton, Ontario, Canada (A.T., M.S., F.J.C., D.H., B.B.D., M.V.)
| | - Anne Boyle
- McMaster University and St. Joseph's Healthcare, Hamilton, Ontario, Canada (D.J.C., J.C.R., A.B.)
| | - Felida Toledo
- St. Joseph's Healthcare, Hamilton, Ontario, Canada (N.H., F.T.)
| | - Brittany B Dennis
- McMaster University, Hamilton, Ontario, Canada (A.T., M.S., F.J.C., D.H., B.B.D., M.V.)
| | - Kirsten Fiest
- University of Calgary, Calgary, Alberta, Canada (K.F.)
| | - Meredith Vanstone
- McMaster University, Hamilton, Ontario, Canada (A.T., M.S., F.J.C., D.H., B.B.D., M.V.)
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Smiechowski J, Stelfox H, Sinclair S, Sinuff T, Grindrod-Millar K, Roze des Ordons A. Vicarious spiritual distress in intensive care unit healthcare providers: A qualitative study. Intensive Crit Care Nurs 2021; 63:102982. [PMID: 33454190 DOI: 10.1016/j.iccn.2020.102982] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/03/2020] [Accepted: 06/22/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To explore the impact of caring for family members experiencing spiritual distress on Intensive Care Unit healthcare providers. DESIGN A qualitative study involving interviews and focus groups between May 2016 and April 2017. PARTICIPANTS Intensive care healthcare providers from nine teaching and three non-teaching units across Alberta, Canada. MEASUREMENTS Transcribed data were analysed using interpretive description. FINDINGS Forty-two participants variably described experiences of vicarious spiritual distress, along with coping strategies and outcomes related to these experiences. Vicarious spiritual distress was experienced as sorrow/distress, helplessness and preoccupation/rumination. Coping strategies were both adaptive (self-awareness/reflection, reframing/resiliency, team support/debriefing, self-care, accepting limitations) and maladaptive (compartmentalising/distancing, substance use). Lastly, the emotional burden of these experiences resulted in both favourable (satisfaction, appreciation) and unfavourable (moral distress, burnout, hopelessness) outcomes. CONCLUSION Our findings describe the novel concept of vicarious spiritual distress as experienced by intensive care healthcare providers and highlight the importance of identifying effective ways to support these professionals throughout their careers to prevent unfavorable outcomes and the perpetuation of maladaptive coping strategies. The adaptive coping strategies described in this study may help inform wellness initiatives and resiliency training tailored to intensive care healthcare providers.
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Affiliation(s)
- Jennifer Smiechowski
- Department of Medicine, Cumming School of Medicine, University of Calgary, Foothills Medical Center, North Tower, Room 910, 1403 29th Street NW, Calgary, Alberta T2N 2T9, Canada
| | - Henry Stelfox
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, McCaig Tower, 3260 Hospital Drive NW, Calgary, Alberta T2N 426, Canada; Department of Community Health Sciences, University of Calgary, Room 3D10, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada
| | - Shane Sinclair
- Faculty of Nursing, University of Calgary, Professional Faculties 2259, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada
| | - Tasnim Sinuff
- Interdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Sunnybrook Health Sciences Center, Room D1 08, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Kathleen Grindrod-Millar
- Department of Community Health Sciences, University of Calgary, Room 3D10, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada
| | - Amanda Roze des Ordons
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, McCaig Tower, 3260 Hospital Drive NW, Calgary, Alberta T2N 426, Canada; Department of Anesthesiology, Cumming School of Medicine, University of Calgary, Foothills Medical Center, North Tower, Room C222, 1403 29th Street NW, Calgary, Alberta T2N 2T9, Canada; Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Tom Baker Cancer Center, Education Office, 1331 29th Street NW, Calgary, Alberta T2N 4N2, Canada.
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Smiechowski J, Stelfox H, Sinclair S, Sinuff T, Grindrod-Millar K, Roze des Ordons A. WITHDRAWN: Vicarious spiritual distress in intensive care unit healthcare providers: A qualitative study. Intensive Crit Care Nurs 2020:102913. [PMID: 32819807 DOI: 10.1016/j.iccn.2020.102913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/03/2020] [Accepted: 06/22/2020] [Indexed: 11/26/2022]
Abstract
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Jennifer Smiechowski
- Department of Medicine, Cumming School of Medicine, University of Calgary, Foothills Medical Center, North Tower, Room 910, 1403 29th Street NW, Calgary, Alberta T2N 2T9, Canada
| | - Henry Stelfox
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, McCaig Tower, 3260 Hospital Drive NW, Calgary, Alberta T2N 426, Canada; Department of Community Health Sciences, University of Calgary, Room 3D10, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada
| | - Shane Sinclair
- Faculty of Nursing, University of Calgary, Professional Faculties 2259, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada
| | - Tasnim Sinuff
- Interdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Sunnybrook Health Sciences Center, Room D1 08, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada
| | - Kathleen Grindrod-Millar
- Department of Community Health Sciences, University of Calgary, Room 3D10, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada
| | - Amanda Roze des Ordons
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, Foothills Medical Centre, McCaig Tower, 3260 Hospital Drive NW, Calgary, Alberta T2N 426, Canada; Department of Anesthesiology, Cumming School of Medicine, University of Calgary, Foothills Medical Center, North Tower, Room C222, 1403 29th Street NW, Calgary, Alberta T2N 2T9, Canada; Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Tom Baker Cancer Center, Education Office, 1331 29th Street NW, Calgary, Alberta T2N 4N2, Canada.
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15
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Takaoka A, Honarmand K, Vanstone M, Tam B, Smith OM, Baker A, LeBlanc A, Swinton M, Neville TH, Clarke FJ, Hancock J, McMullen S, Meade MO, Rose T, Arora S, Cook DJ. Organ Donation at the End of Life: Experiences From the 3 Wishes Project. J Intensive Care Med 2020; 36:404-412. [PMID: 31960743 DOI: 10.1177/0885066619900125] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The 3 Wishes Project (3WP) promotes holistic end-of-life care in the intensive care unit (ICU) to honor dying patients, support families, and encourage clinician compassion. Organ donation is a wish that is sometimes made by, or on behalf of, critically ill patients. Our objective was to describe the interface between the 3WP and organ donation as experienced by families, clinicians, and organ donation coordinators. METHODS In a multicenter evaluation of the 3WP in 4 Canadian ICUs, we conducted a thematic analysis of transcripts from interviews and focus groups with clinicians, organ donation coordinators, and families of dying or died patients for whom donation was considered. RESULTS We analyzed transcripts from 26 interviews and 2 focus groups with 18 family members, 17 clinicians, and 6 organ donation coordinators. The central theme describes the mutual goals of the 3WP and organ donation-emphasizing personhood and agency across the temporal continuum of care. During family decision-making, conversations encouraged by the 3WP can facilitate preliminary discussions about donation. During preparation for donation, memory-making activities supported by the 3WP redirect focus toward personhood. During postmortem family care, the 3WP supports families, including when donation is unsuccessful, and highlights aspirational pursuits of donation while encouraging reflections on other fulfilled wishes. CONCLUSIONS Organ donation and the 3WP provide complementary opportunities to engage in value-based conversations during the dying process. The shared values of these programs may help to incorporate organ donation and death into a person's life narrative and incorporate new life into a person's death narrative.
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Affiliation(s)
- Alyson Takaoka
- Faculty of Health Sciences, Department of Health Research Methods, Evidence, and Impact, 3710McMaster University, Hamilton, Canada.,Co-primary authors
| | - Kimia Honarmand
- Division of Critical Care, Department of Medicine, Western Ontario, London, Canada.,Co-primary authors
| | - Meredith Vanstone
- McMaster program for Education Research Innovation & Theory, Department of Family Medicine, 3710McMaster University, Hamilton, Canada
| | - Benjamin Tam
- Division of Critical Care, Department of Medicine, 37195Niagara Health, St. Catharines, Canada
| | - Orla M Smith
- Critical Care Department, Li Ka Shing Knowledge Institute, 10071St. Michael's Hospital, Toronto, Canada
| | - Andrew Baker
- Department of Anesthesia, 10071St Michael's Hospital, Toronto, Canada.,Department of Critical Care, 10071St Michael's Hospital, Toronto, Canada
| | - Allana LeBlanc
- Department of Critical Care Medicine, Vancouver General Hospital, Vancouver, Canada
| | - Marilyn Swinton
- Faculty of Health Sciences, Department of Health Research Methods, Evidence, and Impact, 3710McMaster University, Hamilton, Canada
| | - Thanh H Neville
- Division of Pulmonary & Critical Care, Department of Medicine, 8783University of California, Los Angeles, CA, USA
| | - France J Clarke
- Department of Critical Care, St Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Jennifer Hancock
- Department of Critical Care, 3688University of Dalhousie, Halifax, Canada
| | - Sarah McMullen
- Department of Critical Care, 3688University of Dalhousie, Halifax, Canada
| | - Maureen O Meade
- Faculty of Health Sciences, Department of Medicine, Faculty, 3710McMaster University, Hamilton, Canada
| | - Trudy Rose
- Department of Spiritual Care, Grand River Hospital, Kitchener, Canada
| | - Samantha Arora
- Department of Medicine, 3710McMaster University, Hamilton, Canada
| | - Deborah J Cook
- Faculty of Health Sciences, Department of Health Research Methods, Evidence, and Impact, 3710McMaster University, Hamilton, Canada.,Faculty of Health Sciences, Department of Medicine, Faculty, 3710McMaster University, Hamilton, Canada
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16
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Pavlish CL, Henriksen J, Brown-Saltzman K, Robinson EM, Warda US, Farra C, Chen B, Jakel P. A Team-Based Early Action Protocol to Address Ethical Concerns in the Intensive Care Unit. Am J Crit Care 2020; 29:49-61. [PMID: 31968085 DOI: 10.4037/ajcc2020915] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Ethical conflicts complicate clinical practice and often compromise communication and teamwork among patients, families, and clinicians. As ethical conflicts escalate, patient and family distress and dissatisfaction with care increase and trust in clinicians erodes, reducing care quality and patient safety. OBJECTIVE To investigate the effectiveness of a proactive, team-based ethics protocol used routinely to discuss ethics-related concerns, goals of care, and additional supports for patients and families. METHODS In a pre-post intervention study in 6 intensive care units (ICUs) at 3 academic medical centers, the electronic medical records of 1649 patients representing 1712 ICU admissions were studied. Number and timing of family conferences, code discussions with the patient or surrogate, and ethics consultations; palliative care, social work, and chaplain referrals; and ICU length of stay were measured. Preintervention outcomes were compared with outcomes 3 and 6 months after the intervention via multivariate logistic regression controlled for patient variables. RESULTS The odds of receiving a family conference and a chaplain visit were significantly higher after the intervention than at baseline. The number of palliative care consultations and code discussions increased slightly at 3 and 6 months. Social work consultations increased only at 6 months. Ethics consultations increased at both postintervention time points. Length of ICU stay did not change. CONCLUSIONS When health care teams were encouraged to communicate routinely about goals of care, more patients received needed support and communication barriers were reduced.
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Affiliation(s)
| | - Joan Henriksen
- Joan Henriksen was the coordinator, Clinical Ethics Consultation Service, Mayo Clinic, Rochester, Minnesota; she is now senior staff ethicist at Children’s Minnesota in Minneapolis
| | | | - Ellen M. Robinson
- Ellen M. Robinson is a nurse ethicist, Massachusetts General Hospital, Boston, Massachusetts
| | | | | | - Belinda Chen
- Belinda Chen is a statistician, University of California, Los Angeles, School of Nursing, Los Angeles, California
| | - Patricia Jakel
- Patricia Jakel is a clinical nurse specialist, Santa Monica Hospital, University of California, Los Angeles, Health System, Los Angeles, California
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17
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Purvis TE, Powell B, Biba G, Conti D, Crowe TY, Thomas H, Carhuapoma JR, Probasco J, Teague P, Saylor D. Staff Perceptions of Chaplains in a Neurosciences Critical Care Unit. JOURNAL OF RELIGION AND HEALTH 2019; 58:2086-2094. [PMID: 31650380 DOI: 10.1007/s10943-019-00935-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Hospital chaplains often visit critically ill patients, but neurosciences critical care unit (NCCU) staff beliefs surrounding chaplains have not been characterized. In this study, we used Qualtrics® to survey 70 NCCU healthcare workers about their attitudes toward chaplains in the NCCU. Chaplains were seen positively by staff but were less likely to be viewed as part of the care team by staff with more than five years of NCCU experience. The results of this study will allow chaplaincy programs to target staff education efforts in order to enhance the care provided to patients in critical care settings.
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Affiliation(s)
- Taylor E Purvis
- Department of Spiritual Care and Chaplaincy, Johns Hopkins University School of Medicine, 1800 Orleans Street, Osler 101, Baltimore, MD, 21287-0019, USA.
| | | | - Gail Biba
- Johns Hopkins Hospital, Baltimore, MD, USA
| | | | | | - Heather Thomas
- Department of Spiritual Care and Chaplaincy, Johns Hopkins University School of Medicine, 1800 Orleans Street, Osler 101, Baltimore, MD, 21287-0019, USA
| | - J Ricardo Carhuapoma
- Department of Spiritual Care and Chaplaincy, Johns Hopkins University School of Medicine, 1800 Orleans Street, Osler 101, Baltimore, MD, 21287-0019, USA
| | - John Probasco
- Department of Spiritual Care and Chaplaincy, Johns Hopkins University School of Medicine, 1800 Orleans Street, Osler 101, Baltimore, MD, 21287-0019, USA
| | | | - Deanna Saylor
- Department of Spiritual Care and Chaplaincy, Johns Hopkins University School of Medicine, 1800 Orleans Street, Osler 101, Baltimore, MD, 21287-0019, USA
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18
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Adams K. Defining and Operationalizing Chaplain Presence: A Review. JOURNAL OF RELIGION AND HEALTH 2019; 58:1246-1258. [PMID: 30565167 DOI: 10.1007/s10943-018-00746-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Presence is a vaguely defined word often used by chaplains to describe their work with patients, families, and staff. The current literature defines presence as a process of creating a trusting atmosphere for nonjudgmental and compassionate sharing in another's story. Presence has no apparent agenda, much flexibility, and requires emotional vulnerability in the chaplain interactions. This presents four problems: distinguishing chaplain presence from presence by other providers; dependence on chaplain vulnerability in the encounter; difficulty of assessing impact on patient/family care; and clearly communicating the importance of presence to the interprofessional team. An operational definition is provided including parameters for care and intended outcomes.
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Affiliation(s)
- Kevin Adams
- Department of Chaplaincy Services and Pastoral Education, University of Virginia Health System, P.O. Box 800672, Charlottesville, VA, 22908-0672, USA.
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