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Mollman S, Gierach M, Sedlacek A. Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar. Am J Hosp Palliat Care 2024; 41:501-507. [PMID: 37321259 DOI: 10.1177/10499091231184623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic created a unique opportunity to evolve an interdisciplinary palliative care seminar (IPC) into a virtual platform. This seminar provides foundational palliative and hospice concepts, introductions into palliative care disciplines, integration of teamwork, and incorporates interdisciplinary student led patient encounters. Traditionally, this experience had been in person, however during the COVID-19 pandemic, healthcare restrictions transitioned the educational delivery to a virtual platform. METHODS To assess the knowledge gained from this novel experience, the Palliative Care Knowledge Test (PCKT) was administered before and after the IPC Seminar. A 1-year follow up survey was also administered to evaluate how the IPC Seminar was applicable to the students' clinical experiences and practice. RESULTS The virtual didactics and virtual student led patient encounters significantly improved learners understanding of palliative and hospice care. This gain of knowledge was noted across undergraduate and graduate programs, which highlights the need for and benefit from foundational concepts. Furthermore, a 1-year follow up survey noted the IPC seminar was applicable to their practices and suggests that this experience will impact future patients. DISCUSSION Many of the students practice in rural areas where access to palliative care services is limited or non-existent. This experience exponentially impacts the growth of palliative and hospice care understanding and access to care across the region. CONCLUSION Evolving our IPC Seminar has shown to significantly improve knowledge, foster collaboration of student led interdisciplinary teams, and increases capacity to meet the needs of more learners.
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Affiliation(s)
- Sarah Mollman
- College of Nursing, South Dakota State University, Brookings, SD, USA
| | | | - Amanda Sedlacek
- Internal, Palliative and Hospice Medicine, Yankton Medical Clinic, Yankton, SD, USA
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Tunks Leach K, Demant D, Simpson P, Lewis J, Levett-Jones T. Chaplaincy and spiritual care in Australian ambulance services: an exploratory cross-sectional study. J Health Care Chaplain 2024:1-24. [PMID: 38574262 DOI: 10.1080/08854726.2024.2323371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Ambulance staff wellbeing programs aim to support the bio-psycho-social and sometimes spiritual needs of paramedics. While evidence demonstrates strong connections between spirituality and/or religion to wellbeing outcomes, little is known about spiritual care in ambulance services or its impact. The aim of this study was to investigate paramedics' perspectives on the role and value of Australian ambulance chaplains. A cross-sectional online study of registered paramedics in Australia was conducted between November and December 2022. Analysis of the 150 responses identified that paramedics viewed the chaplain's role as one built on professional caring relationships that provided proactive and reactive care in paramedic workplaces. Chaplains were perceived to promote wellbeing by incorporating emotional, psychological, social and spiritual care, and assisting paramedics to access additional support. Perceived religiousness of chaplains and organisational factors were barriers to paramedics accessing chaplains, while pre-existing relationships and shared experiences positively influenced paramedics decision to seek chaplain support.
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Affiliation(s)
- Katie Tunks Leach
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Daniel Demant
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, OLD, Australia
| | - Paul Simpson
- School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
| | | | - Tracy Levett-Jones
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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3
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Cullinan RJ, Woods A, Barber JM, Cook CCH. Spiritually significant hallucinations: a patient-centred approach to tackle epistemic injustice. BJPsych Bull 2024; 48:133-138. [PMID: 37042321 PMCID: PMC10985729 DOI: 10.1192/bjb.2023.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 04/13/2023] Open
Abstract
SUMMARY This article uses three fictitious case vignettes to raise questions and educate on how clinicians can appropriately approach patients experiencing spiritually significant hallucinations. Religious hallucinations are common but are not pathognomonic of mental illness. They are often intimate experiences for the patient that raise complex questions about psychopathology for clinicians. When assessing a patient with religious hallucinations it is important that clinicians hold at the centre that person's personal experience and create a safe space in which they are listened to and epistemic injustices are avoided. Involvement of chaplaincy services is important not just to support the patient but also to ensure that as clinicians we seek support in understanding the religious nature of these experiences.
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Affiliation(s)
- Rachel J. Cullinan
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Newcastle University, Newcastle upon Tyne, UK
| | | | - Joanna M.P. Barber
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK
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4
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Miller S, Stephens CWB. Assessing Impact Amongst Chaplains in a University Setting: Phase Two of an Action Research Project. J Pastoral Care Counsel 2024:15423050241228305. [PMID: 38317279 DOI: 10.1177/15423050241228305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
This article, the result of an Action Research project, describes the process of creating and testing a resource for assessing the contribution of chaplaincy in a British university setting, and the resultant insights and outcomes: organisational and individual learning, changes in chaplains' attitudes to monitoring and evaluation, and a resource which is perceived as having benefits and limitations. This article considers the evaluation process as applied to chaplaincy and offers a model for further testing.
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Affiliation(s)
- Sue Miller
- Susanna Wesley Foundation, Southlands College, London, UK
- Southlands College, University of Roehampton, London, UK
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5
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den Toom N, Visser A, Körver J, Walton MN. The perceived impact of being a chaplain-researcher on professional practice. J Health Care Chaplain 2024; 30:19-32. [PMID: 36264014 DOI: 10.1080/08854726.2022.2132036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
As research has become part of chaplaincy, many chaplains become involved in research, often in the double-role of chaplain-researcher. Despite the increase of involvement in research, how conducting research benefits chaplains' professional care for clients has not been studied. The present study aimed to describe how chaplains perceive the impact of participation in the Dutch Case Studies Project (CSP) on their professional expertise and positioning in the institution. A survey was distributed among participants of the CSP (N = 50) and was completed by 48 participants. We found that participation in research contributed to the expertise of chaplains (e.g., its goal-orientation, the use of theory and method) and their positioning as they try to legitimate their profession. This study thus substantiates the presumption that chaplains' engaging in research as chaplain-researcher contributes to the perceived improvement of the quality of chaplaincy care and its legitimation.
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Affiliation(s)
- Niels den Toom
- Department of Practical Theology and Religious Studies, Tilburg School of Catholic Theology, Tilburg University, Tilburg, the Netherlands
| | - Anja Visser
- Faculty of Theology and Religious Studies, University of Groningen, Groningen, the Netherlands
| | - Jacques Körver
- Department of Practical Theology and Religious Studies, Tilburg School of Catholic Theology, Tilburg University, Tilburg, the Netherlands
| | - Martin N Walton
- Department of Practices, Protestant Theological University, Groningen, the Netherlands
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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 2023:1-14. [PMID: 37811644 DOI: 10.1080/08854726.2023.2266303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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.
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Affiliation(s)
| | | | | | | | | | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA
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7
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Allison E, Woodhall J, Briggs M, Swift C. Reconfiguring the health-promoting hospital: the role of chaplaincy in England. Health Promot Int 2023; 38:daad068. [PMID: 37440253 DOI: 10.1093/heapro/daad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
This paper seeks to explore how hospitals can be reconfigured to adopt more 'health-promoting' approaches and values. Specifically, the paper focuses on the role of hospital chaplaincy and argues that spiritual care should be considered alongside other health domains. Using semi-structured interviews, the aim of the paper is to explore the experiences of patients who accepted (n = 10) and declined (n = 10) hospital chaplaincy services. Data were analysed drawing on principles of interpretative phenomenological analysis (IPA). The findings suggested that participants who accessed chaplaincy services reported using the chaplains for pastoral, religious and spiritual care which contributed positively to their sense of well-being. This included religious rituals and supportive conversations. The majority of these participants had existing links with a faith institution. Participants who declined chaplaincy services reported having personal religious or spiritual beliefs. Other reasons cited, included: that the offer was made close to discharge; they had different support mechanisms; they were unaware of what the chaplaincy service offered. Participants identified a number of skills and attributes they associated with chaplains. They perceived them as being religious but available to all, somebody to talk to who was perceived as impartial with a shared knowledge and understanding. The paper concludes by highlighting the important role of chaplaincy as part of a holistic health-promoting hospital. This has implications not only for the design, delivery and promotion of chaplaincy services but also for health promotion more broadly to consider spiritual needs.
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Affiliation(s)
| | | | - Michelle Briggs
- Clinical Professor of Nursing & Director, Manchester Clinical Academic Centre (MCAC) for Nurses, Midwives and AHPs (NMAHPs), Manchester NHS Foundation Trust/University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Chris Swift
- Visiting Professor, Religious, Spiritual and Pastoral Care, Staffordshire University
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Cadge W, Savage B, Barnes M. Chaplains of Color: Histories and Practices. J Health Care Chaplain 2023:1-11. [PMID: 37166788 DOI: 10.1080/08854726.2023.2210028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
From the gallows and fields of war to the street and bedside, chaplains of color have been present and instrumental in providing spiritual and emotional support in public and private settings across the United States. Their histories and experiences are not well documented and integrated into the field of spiritual care and chaplaincy, a field often understood as predominantly White, male, and Christian. This article introduces this special issue by offering historical context-particularly for Black chaplains-and naming the key themes that weave through the articles included. Naming the experiences of chaplains of color is a central step in responding to historically grounded racial inequities in the work of chaplaincy and spiritual care in the United States.
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Affiliation(s)
- Wendy Cadge
- Department of Sociology, Brandeis University, Waltham, MA, USA
| | - Barbara Savage
- Department of Africana Studies, University of Pennsylvania, Philadelphia, PA, USA
| | - Marilyn Barnes
- Department of Patient Counseling, College of Health Professions, Virginia Commonwealth University
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Cadge W. Racial burdens in the work experiences of state-supported Black chaplains. J Health Care Chaplain 2023:1-10. [PMID: 37163227 DOI: 10.1080/08854726.2023.2210027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
To understand and improve the experiences of Black chaplains, it is essential to consider how they experience and are integrated into their workplaces. This article draws from interviews with ten Black chaplains in the military and prisons. In light of historic, state-sanctioned, discrimination in these institutions, we ask how these chaplains experience their workplaces racially. All experience racial burdens in the workplace as part of being the first or only Black chaplain or in response to overt racial discrimination. They identify few to no formal workplace efforts to support them as Black chaplains and spoke of resistance to informal efforts that have been tried over the years. State and federal workplaces must recognize the racial burdens Black chaplains' experiences and take action to respond to and support these systemic workplace issues.
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Affiliation(s)
- Wendy Cadge
- Department of Sociology, Brandeis University, Waltham, MA, USA
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11
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Leavitt-Alcántara S, Betz J, Medeiros Almeida D, Ferrara B, Xu Y, Diop E, Hamilton O, Young C, Ragsdale JR. Religiosity and religious and spiritual struggle and their association to depression and anxiety among adolescents admitted to inpatient psychiatric units. J Health Care Chaplain 2023; 29:1-13. [PMID: 35188877 DOI: 10.1080/08854726.2022.2040227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study examines the relationship between religious and spiritual (R/S) struggle and religiosity with depression and anxiety in adolescents admitted to inpatient psychiatric units of a pediatric hospital in the Midwest of the United States. We administered four self-reported scales to 71 adolescents (ages 13-17) to assess religiosity, R/S struggle, depression, and anxiety. The prevalence of R/S struggle among this population was high (88.73%). Significant associations were found between R/S struggle and depression and anxiety, linking greater R/S struggles with more severe depression or anxiety. However, no significant associations between religiosity and depression and anxiety were noted. By examining the prevalence of R/S struggle among this population and its relationship to depression and anxiety, this study contributes to the expanding research on the impact of religion and spirituality on the psychological well-being of adolescents.
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Affiliation(s)
- Salvador Leavitt-Alcántara
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - John Betz
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Daniel Medeiros Almeida
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Brycen Ferrara
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Yingying Xu
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Elizabeth Diop
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Olivia Hamilton
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Chris Young
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Judith R Ragsdale
- Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
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Abstract
In sociological studies of religion and chaplaincy, there is little research on how gender plays a role in structural inequalities and experiences of women chaplains. Through research on the work of women chaplains in public healthcare in Vancouver (Canada) and London (England) this qualitative study revealed that while they have opportunities for leadership and ministry in chaplaincy, they are often on the margins of the religious institutions they are affiliated with and the secular medical organisations that employ them. Simultaneously, they confront the social structuring of gender and race that can affect them being overlooked. By applying a lived religion and feminist intersectional analysis, this research focuses on an area of study that has received scant attention.
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Affiliation(s)
- Sonya Sharma
- Sonya Sharma, Social Research Institute, University College London, 27-28 Woburn Square, London WC1H 0AA, UK.
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13
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Obold Eshleman SF, Varner Perez SE. "I Don't Do Religion": Using Nature Photographs to Engage Patients in Spiritual Reflection. J Pain Symptom Manage 2022; 64:e305-e309. [PMID: 34389416 DOI: 10.1016/j.jpainsymman.2021.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/10/2021] [Accepted: 07/31/2021] [Indexed: 12/24/2022]
Abstract
When caring for healthcare patients, professional chaplains may find an increasing proportion of individuals in the U.S. who do not identify as religious and who may benefit from creative approaches to discussing their spiritual and existential concerns. One approach to engaging patients is using a "third voice," as shared in a personal narrative in which a chaplain uses landscape photographs to engage a patient for discussion of spiritual and existential concerns. The content of the conversation may inform decisions about treatment, quality of life, and person-centered care.
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Affiliation(s)
| | - Shelley E Varner Perez
- Indiana University (IU) Health, Indianapolis, Indiana, USA; IU Center for Aging Research, Regenstrief Institute, Inc., Indianapolis, Indiana, USA; Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, IU Health, Indianapolis, Indiana, USA
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Garces-Foley K. New Faces at the Bedside: Death Doulas, Vigilers, and Companions. Omega (Westport) 2022:302228221133436. [PMID: 36227020 DOI: 10.1177/00302228221133436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A growing number of nonmedical caregivers seek to improve dying in the United States. They call themselves end-of-life doulas, death midwives, soul guides, compassionate companions, and vigilers, among other names. These new faces at the bedside share a common goal of comforting the dying and their loved ones. Their work is both humanitarian and spiritual as they bring compassionate presence into the sacred space of dying. Thousands of individuals provide end-of-life caregiving through volunteer programs in hospitals, hospices, and community non-profits; hundreds more provide their services to clients for a fee. Using in-depth interviews and analysis of print and online materials, this article traces the development of nonmedical end-of-life caregiving from volunteer vigiling and companioning programs to the professionalization of end-of-life doulaing. Though professional doulas are in the media spotlight, this work began with volunteers who continue to provide most of the nonmedical end-of-life care support for the dying in the United States.
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Patel RV. The Missing Voice: Incorporating the Hindu Community in Developing Inclusive Chaplaincy. J Pastoral Care Counsel 2022; 76:160-161. [PMID: 35942804 DOI: 10.1177/15423050221119179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This manuscript highlights potential barriers hospitalized Hindu patients and caregivers living in the United States encounter while accessing chaplaincy care. Community-based participatory research is suggested to foster partnerships between chaplains and the Hindu community in developing evidence-based, inclusive models of pastoral care.
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Affiliation(s)
- Rushil V Patel
- Department of Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
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Earl BSW, Klee A, Edens EL, Cooke JD, Heikkila H, Grau LE. Healthcare Providers' Perceptions about the Role of Spiritual Care and Chaplaincy Services in Substance Use Outpatient Treatment. Int J Environ Res Public Health 2022; 19:ijerph19159441. [PMID: 35954792 PMCID: PMC9367702 DOI: 10.3390/ijerph19159441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023]
Abstract
Addressing patients' religion and spirituality (R/S) needs has been associated with positive health outcomes. However, despite receiving extensive training in spiritual assessment and care, chaplaincy services are primarily confined to inpatient settings, with few studies occurring in outpatient settings. The study sought to understand mental health providers' views about what shaped provider and patient motivation to engage in R/S discussions and seek referrals to chaplaincy services. We conducted five one-hour focus group sessions with a total of 38 staff members and thematically analyzed the resulting session and field notes. We identified four themes concerning provider knowledge and attitudes about R/S and chaplaincy services: Staff Information Needs, Staff Motivation to Discuss R/S and Refer, Patient Motivation to Use Chaplaincy Services, and Chaplain Accessibility. The study findings suggest that providers in outpatient substance use treatment clinics in the Veterans Health Administration are receptive to learning about R/S care and the possibility of expanding chaplaincy services. However, staff have misconceptions about the roles and responsibilities of chaplains. Attitudes about and experiences with R/S discussions varied. Trust and confidence in the benefits of chaplaincy services may be improved among both providers and patients by increasing chaplains' accessibility and visibility within these outpatient settings.
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Affiliation(s)
- Brian S. W. Earl
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Chaplain Services, Veterans Administration Hospital, Albuquerque, NM 87108, USA
| | - Anne Klee
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - Ellen L. Edens
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, USA
| | - James D. Cooke
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
| | - Holly Heikkila
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Chaplain Services, Milwaukee Veterans Administration Hospital, Milwaukee, WI 53215, USA
- Spiritual Life Office, University of Chicago, Chicago, IL 60637, USA
| | - Lauretta E. Grau
- Departments of Chaplain Services and Mental Health Service Line, Veterans Administration Hospital, West Haven, CT 06516, USA; (B.S.W.E.); (A.K.); (E.L.E.); (J.D.C.); (H.H.)
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06511, USA
- Correspondence: ; Tel.: +1-203-785-2904
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Gelfand SL, Fitchett G, Moss AH. Recognizing the Potential Importance of Religion and Spirituality in the Care of Black Americans with Kidney Failure. J Am Soc Nephrol 2022; 33:1255-1257. [PMID: 35304429 PMCID: PMC9257821 DOI: 10.1681/asn.2021101367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Samantha L Gelfand
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts .,Harvard Medical School, Boston, Massachusetts.,Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, Illinois
| | - Alvin H Moss
- Section of Nephrology, West Virginia University School of Medicine, Morgantown, West Virginia.,Section of Geriatrics and Palliative Medicine, West Virginia University School of Medicine, Morgantown, West Virginia.,Center for Health Ethics and Law, West Virginia University Health Sciences Center, Morgantown, West Virginia
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Szilagyi C, Vandenhoeck A, Best MC, Desjardins CM, Drummond DA, Fitchett G, Harrison S, Haythorn T, Holmes C, Muthert H, Nuzum D, Verhoef JHA, Willander E. Chaplain Leadership During COVID-19: An International Expert Panel. J Pastoral Care Counsel 2022; 76:56-65. [PMID: 34931932 PMCID: PMC8926913 DOI: 10.1177/15423050211067724] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Chaplain leadership may have played a pivotal role in shaping chaplains' roles in health care amidst the COVID-19 pandemic. We convened an international expert panel to identify expert perception on key chaplain leadership factors. Six leadership themes of professional confidence, engaging and trust-building with executives, decision-making, innovation and creativity, building integrative and trusting connections with colleagues, and promoting cultural competencies emerged as central to determining chaplains' integration, perceived value, and contributions during the pandemic.
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Affiliation(s)
- Csaba Szilagyi
- Csaba Szilagyi, Johns Hopkins Medicine, 5755 Cedar Lane, Columbia, MD 21044, USA.
| | - Anne Vandenhoeck
- Faculty of Theological and Religious Studies, KU Leuven, Leuven, Belgium; European Research Institute for Chaplains in Healthcare, Leuven, Belgium
| | - Megan C. Best
- Institute for Ethics and Society, University of Notre Dame Australia, Sydney, Australia
| | | | | | - George Fitchett
- Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA; Transforming Chaplaincy, Chicago, IL, USA
| | | | - Trace Haythorn
- ACPE: The Standard for Spiritual Care and Education, Atlanta, GA, USA
| | - Cheryl Holmes
- Spiritual Health Association, Melbourne, Australia; School of Public Health and Psychology, La Trobe University, Melbourne, Australia
| | - Hanneke Muthert
- Faculty of Theology and Religious Studies, University of Groningen, Groningen, the Netherlands
| | - Daniel Nuzum
- University College Cork, Cork University Hospital, Cork, Ireland; Association of Clinical Pastoral Education (Ireland) Ltd
| | - Joost H. A. Verhoef
- OLVG, Amsterdam, the Netherlands; European Research Institute for Chaplains in Healthcare, Leuven, Belgium
| | - Erika Willander
- Department of Sociology, Uppsala University, Uppsala, Sweden
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19
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van Dijke J, Duyndam J, van Nistelrooij I, Bos P. "We Need to Talk About Empathy": Dutch Humanist Chaplains' Perspectives on Empathy's Functions, Downsides, and Limitations in Chaplaincy Care. J Pastoral Care Counsel 2022; 76:15-28. [PMID: 35068263 DOI: 10.1177/15423050221074271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This paper investigates the functions, downsides, and limitations of empathy in chaplaincy care. Data were collected from 20 humanist chaplains working in health care, prison, and military settings using semi-structured interviews. According to the participants, empathy is at the heart of their profession but has disadvantages as well. The analysis yields seven major functions of empathy with corresponding downsides and limitations: (1) to connect, (2) to understand, (3) to guide, (4) to acknowledge, (5) to motivate, (6) to inspire, and (7) to humanize. We argue for a need to "talk about empathy" since despite its importance and challenges, there is little professional and academic discussion about empathy in chaplaincy care. We hope that the findings of this study can function as starting points for the discussion and thus contribute to the ongoing professionalization of chaplaincy care. To that end, we propose three topics for further reflection and conversation.
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Affiliation(s)
| | - Joachim Duyndam
- Philosophy, University of Humanistic Studies, Utrecht, the Netherlands
| | | | - Pien Bos
- Research Methodology, University of Humanistic Studies, Utrecht, the Netherlands
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20
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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21
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Hirschmann J, Kozato A, Sharma V, Villagra C, Wetmore J, Jandorf L, Pang JH, Reynolds M, Dodge L, Mejía S, Safer JD. An Analysis of Chaplains' Narrative Chart Notes Describing Spiritual Care Visits with Gender Affirmation Surgical Patients. Transgend Health 2022; 7:92-100. [PMID: 36644021 PMCID: PMC9829152 DOI: 10.1089/trgh.2020.0030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose The benefit of spiritual care for patients is well described, but little is known about the role of spiritual care in transgender and nonbinary patients recovering from gender affirming surgeries (GASs). Methods A single-center retrospective chart review was performed on patients who underwent GAS in 2017. Demographic information, surgery type, and chaplains' narrative notes were examined. Results A total of 145 chaplain visits were identified in 103 inpatient stays among 98 patients at the Mount Sinai Center for Transgender Medicine and Surgery in New York. Analysis was performed on narrative notes authored by a single chaplain, which included 132 visits among 78 transfeminine and 11 transmasculine patients. Fifty-four patients (61%) expressed gratitude for the chaplain visit and/or hospital experience overall. Seven patients (8%) described movement between religious denominations over the course of their lives, and 7 (8%) described supportive belief systems. Fifty-seven patients (64%) had a family member or friend present during the perioperative process, 13 (15%) described support systems, and 9 (10%) described supportive practices, activities, and/or coping methods. Twenty-one patients (24%) expressed concerns about current symptoms or the recovery process, and 32 (36%) received a prayer or blessing from the chaplain. Fifty-two patients (58%) consented to a follow-up call. Conclusion Almost 50% of patients expressed gratitude for the chaplain's visit and more than half consented to a follow-up call from the chaplain, suggesting a chaplain can provide a welcome layer of support to postoperative GAS patients. The authors recommend integrating spiritual care into perioperative care.
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Affiliation(s)
- Jo Hirschmann
- Mount Sinai Center for Transgender Medicine and Surgery, Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Address correspondence to: Jo Hirschmann, MAHL, Mount Sinai Center for Transgender Medicine and Surgery, Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, 10 Nathan D. Perlman Place, New York, NY 10003, USA,
| | - Aki Kozato
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vansh Sharma
- Department of Psychiatry, Center for Spirituality and Health, Center for Stress, Resilience and Personal Growth, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Cristina Villagra
- Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John Wetmore
- Mount Sinai Health System, New York, New York, USA
| | - Lina Jandorf
- Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John Henry Pang
- Mount Sinai Center for Transgender Medicine and Surgery, Department of Surgery, Division of Plastic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Leanne Dodge
- Department of Spiritual Care and Education, Mount Sinai Beth Israel, New York, New York, USA
| | - Silvia Mejía
- Department of Spiritual Care and Education, Mount Sinai Beth Israel, New York, New York, USA
| | - Joshua D. Safer
- Mount Sinai Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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22
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Alghanim F, Furqan M, Prichett L, Landon J, Tao X, Selvam P, Leslie M, Hartman-Shea K, Teague P, Scott W, Kraeuter S, Hicks H, Jain S, York S, Blanding R, Zakaria S. The Effect of Chaplain Patient Navigators and Multidisciplinary Family Meetings on Patient Outcomes in the ICU: The Critical Care Collaboration and Communication Project. Crit Care Explor 2021; 3:e0574. [PMID: 34765982 DOI: 10.1097/CCE.0000000000000574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To assess the effectiveness of a chaplain patient navigator in improving outcomes and reducing costs in the ICU setting. DESIGN A randomized controlled trial at a large, urban, academic community hospital in Baltimore, Maryland. SETTING/PATIENTS All patients admitted to the Johns Hopkins Bayview Medical Center Cardiac and Medical ICUs between March 2015 and December 2015. INTERVENTIONS Patients in the intervention group were assigned a chaplain patient navigator to facilitate communication, offer support, and setup multidisciplinary family meetings. MEASUREMENTS AND MAIN RESULTS The primary outcomes were hospital and ICU length of stay. Secondary outcomes included total and ICU charges, 60- and 90-day readmission rates, and the number of palliative care consults. For all outcomes, patients were included in the intention-to-treat analyses only if they remained in the ICU greater than 24 hours. In total, 1,174 were randomly assigned to "usual care" (n = 573) or to the intervention (n = 601). In the intervention group, 44.8% (269/601) had meetings within 24 hours of admission and, of those patients, 32.8% (88/268) took part in the larger multidisciplinary family meeting 2-3 days later. The intervention group had longer mean adjusted hospital length of stay (7.78 vs 8.63 d; p ≤ 0.001) and mean ICU length of stay (3.65 vs 3.87 d; p = 0.029). In addition, they had greater total and ICU charges. There were no differences in other outcomes. Of note, only differences in total and ICU charges remained when controlling for case-mix index, which were greater in the intervention group. CONCLUSIONS Although the chaplain patient navigator anecdotally enhanced communication, our study found an increase in hospital and ICU length of stay as well as cost. Since other studies have shown benefits in some clinical outcomes, projects focused on patient navigators may learn lessons from our study in order to better prioritize family meetings, gather indicators of communication quality, and identify the optimal patient navigator operational context.
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23
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Byrne-Martelli S. The Still, Small Voice of Grief. J Pain Symptom Manage 2021; 62:1100-1102. [PMID: 32822752 PMCID: PMC7836895 DOI: 10.1016/j.jpainsymman.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 10/30/2022]
Abstract
When caring for a grieving patient, professional chaplains may assess the patient's spiritual suffering, address questions of meaning and purpose, and identify sources of comfort, love, and strength. In the setting of a pandemic, with heightened precautions and limited visitation by loved ones, all members of the clinical team are called to utilize compassionate listening and communication skills to address the pervasive isolation and grief of those in their care. This article uses a chaplain's personal narrative to explore the challenges of facilitating grief support with a newly bereaved patient who cannot speak. It presents the Biblical concept of kol d'mama daka, the "still small voice," as an image of the power of silence and revelation that comes when clinicians employ deep listening and compassion.
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Affiliation(s)
- Sarah Byrne-Martelli
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
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24
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Abdulkadir A, Long IJ. The Impact of Privatization on Minority Faith Prison Chaplains in Canada. J Pastoral Care Counsel 2021; 75:199-206. [PMID: 34763568 DOI: 10.1177/15423050211032124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Canadian federal prison chaplaincy underwent a major shift in 2013 when the provision of its services was privatized and outsourced to a single for-profit company. This article presents a summary of the experiences and concerns expressed by minority faith chaplains serving in federal correctional institutions following privatization. It is based on ten in-depth, semi-structured interviews with minority faith prison chaplains. The results show that minority faith federal prison chaplains are concerned about increased levels of bureaucratization that have compromised the quality of spiritual care available to prisoners, reductions in resources for chaplains, and increased levels of emotional exhaustion and frustration among themselves and fellow minority faith chaplains serving in Canadian correctional facilities.
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25
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Fleenor DW, Cummins P, Hirschmann J, Sharma V. Ethics education in clinical pastoral education: prevalence and types. J Health Care Chaplain 2021; 28:285-294. [PMID: 33909539 DOI: 10.1080/08854726.2021.1916335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chaplains frequently serve on ethics committees, as ethics consultants, and as Institutional Review Board (IRB) members in hospitals. However, little is known about how Clinical Pastoral Education (CPE) residents are trained in ethics and whether this training is appropriate or adequate for chaplains' subsequent work in health care settings. We created a survey to canvas 222 CPE residency programs in the United States accredited by the ACPE: The Standard for Spiritual Care (ACPE) to inquire about the prevalence of ethics curricula within residency programs, the educational structure of ethics curricula, and challenges associated with teaching ethics within CPE. We received a total of 84 responses for a 38% response rate. Of these, three-quarters of the programs had a required ethics curriculum, another 10% were in the process of developing one, and 18% had none. There was a great deal of variability in the ethics curricula among the different programs. Developing guidelines for a standardized ethics curriculum could help healthcare chaplains provide more effective service on ethics committees, as ethics consultants, and as IRB members.
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Affiliation(s)
- David W Fleenor
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Cummins
- Bioethics Program, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jo Hirschmann
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vansh Sharma
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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26
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Flynn E. "We Need to Learn from What we Have Learned!": The Possible Impact of Covid-19 on the Education and Training of Chaplains. J Pastoral Care Counsel 2021; 75:37-40. [PMID: 33730914 PMCID: PMC7975851 DOI: 10.1177/1542305021996228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The responses of chaplains providing care in health services during the Covid-19 pandemic showed that they both learned new skills and taught these to others while working in environments made unfamiliar by personal protective equipment and social distancing. This paper discusses the responses of the participants as they relate to education and training as well as suggesting new content and styles of education to meet the needs of chaplains in future similar events.
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Affiliation(s)
- Eleanor Flynn
- Eleanor Flynn, University of Divinity, Melbourne, Australia.
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27
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Abstract
This paper focuses on the impact of COVID19 in Australia. Three areas were investigated: professionalism, contrasting hospital and aged care services and "business as usual"? Impact was low overall, the timing being pre-second wave impact. Two areas of weakness were highlighted: depleted spiritual care teams due to standing down non-professional staff and uncertainty about the role of Chaplains in the care of other staff. Further study of second wave impact is recommended.
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Affiliation(s)
- Heather Tan
- Heather Tan, Spiritual Health Association,
Melbourne, Australia.
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28
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Handzo RG, Hughes RB. Commentary on Chaplain-Physician Interactions From the Chaplain's Perspective: A Mixed Method Analysis. Am J Hosp Palliat Care 2021; 39:144-146. [PMID: 33739151 DOI: 10.1177/10499091211003080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Gomez and her colleagues have presented a helpful study of the relationship of the chaplains in her health system to physicians which highlights several barriers to a well-integrated relationship and thus to more optimal patient care. We have seen these same barriers as we have consulted with health systems nationally and have also identified many best practices that mediate or even eliminate many of these barriers. This commentary describes some of what we have seen as chaplain-generated causes of those barriers and effective strategies that have been employed to overcome them. We also provide some resources for chaplains who wish to institute some of these best practices themselves.
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Affiliation(s)
- Rev George Handzo
- Health Services Research & Quality, 101595HealthCare Chaplaincy Network, New York, NY, USA
| | - Rev Brian Hughes
- Programs and Services, 101595HealthCare Chaplaincy Network, New York, NY, USA
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29
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van Holten W. A Chaplain's View on Religious Delusions (and Other Extraordinary Experiences): Towards a Theological Framework of Understanding. J Pastoral Care Counsel 2021; 75:4-12. [PMID: 33843309 DOI: 10.1177/1542305020967327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this article, the author discusses the question of how to evaluate delusions with religious or spiritual content from a theological perspective. How does a spiritual care practitioner listen to such delusions? The author proposes a theory of meaning that can account for both ordinary and extraordinary experiences and discusses a list of theological criteria in terms of which spiritual care practitioners can understand delusional and other extraordinary experiences and beliefs with spiritual content.
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30
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Simeone IM, Berning JN, Hua M, Happ MB, Baldwin MR. Training Chaplains to Provide Communication-Board-Guided Spiritual Care for Intensive Care Unit Patients. J Palliat Med 2021; 24:218-225. [PMID: 32639178 PMCID: PMC7840304 DOI: 10.1089/jpm.2020.0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2020] [Indexed: 11/12/2022] Open
Abstract
Background: Chaplain-led communication-board-guided spiritual care may reduce anxiety and stress during an intensive care unit (ICU) admission for nonvocal mechanically ventilated patients, but clinical pastoral education does not teach the assistive communication skills needed to provide communication-board-guided spiritual care. Objective: To evaluate a four-hour chaplain-led seminar to educate chaplains about ICU patients' psychoemotional distress, and train them in assistive communication skills for providing chaplain-led communication-board-guided spiritual care. Design: A survey immediately before and after the seminar, and one-year follow-up about use of communication-board-guided spiritual care. Subjects/Setting: Sixty-two chaplains from four U.S. medical centers. Measurements: Multiple-choice and 10-point integer scale questions about ICU patients' mental health and communication-board-guided spiritual care best practices. Results: Chaplain awareness of ICU sedation practices, signs of delirium, and depression, anxiety, and post-traumatic stress disorder in ICU survivors increased significantly (all p < 0.001). Knowledge about using tagged yes/no questions to communicate with nonvocal patients increased from 38% to 87%, p < 0.001. Self-reported skill and comfort in providing communication-board-guided spiritual care increased from a median (interquartile range) score of 4 (2-6) to 7 (5-8) and 6 (4-8) to 8 (6-9), respectively (both p < 0.001). One year later, 31% of chaplains reported providing communication-board-guided spiritual care in the ICU. Conclusions: A single chaplain-led seminar taught chaplains about ICU patients' psychoemotional distress, trained chaplains in assistive communication skills with nonvocal patients, and led to the use of communication-board-guided spiritual care in the ICU for up to one year later.
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Affiliation(s)
- Ilaria M. Simeone
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Joel N. Berning
- Pastoral Care and Education Department, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA
| | - May Hua
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Mary Beth Happ
- Center for Research and Health Analytics, Ohio State University College of Nursing, Columbus, Ohio, USA
| | - Matthew R. Baldwin
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
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Abstract
Hospice and palliative care are in the beginning stages of providing inclusive care to older lesbian, gay, bisexual, transgender, queer (LGBTQ) patients. This inclusivity is exceedingly more pressing given the growing population of out and aging LGBTQ individuals. Hospice and palliative literature recognizes that spirituality and religion can be fraught topics for LGBTQ patients. A few resources are available to help providers give more inclusive care. Few in hospice and palliative care, however, explicitly outline the direct connection for LGBTQ elders between their sexuality and their spiritual lives. 16 LGBTQ individuals born before 1964 were interviewed in the Colorado Front Range. Keeping with the tradition of critical theory, participants were asked "is there a connection for you between your sexuality and your spirituality? if so, what?" The interviews were analyzed using a qualitative conceptual content analysis method. All 16 participants responded that there was a connection for them. The participants expanded on this connection using five themes in their answers: the sexual act itself is spiritual; their authentic LGBTQ journey as spiritual; love/attraction is spiritual; spirituality and sexuality are inseparable; and finally, noting the ineffability of the sexuality-spirituality connection.
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Affiliation(s)
- Tyler Mark Fair
- Honors Department, 1877University of Colorado Boulder, Boulder, CO, USA
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32
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Rosenberg LB, Goodlev ER, Izen RSE, Gelfand SL, Goodlev CL, Lanckton RB, Skarf LM, Wershof Schwartz A, Jones CA, Tulsky JA. Top Ten Tips Palliative Care Clinicians Should Know About Caring for Jewish Patients. J Palliat Med 2020; 23:1658-1661. [PMID: 33085936 DOI: 10.1089/jpm.2020.0601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Judaism, one of the world's oldest religions, claims an estimated 14.3 million members worldwide. There is great diversity in terms of identity, practice, and belief among people who identify as Jewish. As of 2017, 40% of the global Jewish community resided in the United States, making it essential for palliative care clinicians to understand religious and cultural issues related to their serious illness care. In this article, we will discuss 10 important concepts relevant to the inpatient care, advance care planning, and bereavement needs of Jewish patients and families.
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Affiliation(s)
- Leah B Rosenberg
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Eric R Goodlev
- Division of Palliative Care, Department of Medicine, Einstein Medical Center Montgomery, East Norriton, Pennsylvania, USA
| | - Rabbi Shulamit E Izen
- Spiritual Care Department, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Samantha L Gelfand
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | | | - Lara M Skarf
- Division of Geriatrics and Palliative Care, Department of Medicine, Education and Clinical Centers, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA
| | - Andrea Wershof Schwartz
- New England Geriatric Research, Education and Clinical Centers, Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA.,Department of Medicine/Division of Aging, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Christopher A Jones
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - James A Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts, USA
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33
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Ferrell BR, Handzo G, Picchi T, Puchalski C, Rosa WE. The Urgency of Spiritual Care: COVID-19 and the Critical Need for Whole-Person Palliation. J Pain Symptom Manage 2020; 60:e7-e11. [PMID: 32629084 PMCID: PMC7332903 DOI: 10.1016/j.jpainsymman.2020.06.034] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/22/2022]
Abstract
The coronavirus disease 2019 (COVID-19) crisis has amplified the importance of palliative care to countless patients suffering with and dying from this disease, as well as to their families, communities, and the worldwide cadre of overburdened health care workers. Particularly urgent is the need for spiritual care specialists and generalists to address spiritual suffering given the degree of isolation, loneliness, and vulnerability caused by this pandemic. Although spiritual care has long been recognized as one of the domains of quality palliative care, it is often not fully integrated into practice. All disciplines are ultimately responsible for ensuring that spiritual care is prioritized to improve quality of life and the experience of patients and families facing spiritual emergencies amid the complex life-and-death scenarios inherent to coronavirus disease 2019. Although the pandemic has revealed serious fault lines in many health care domains, it has also underscored the need to recommit to spiritual care as an essential component of whole-person palliative care.
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Affiliation(s)
- Betty R Ferrell
- Division of Nursing Research and Education, City of Hope National Medical Center, Duarte, California, USA.
| | - George Handzo
- Health Services Research & Quality, HealthCare Chaplaincy Network, New York, New York, USA
| | - Tina Picchi
- Cambia Health Foundation Sojourns Scholar Program, Camarillo, California, USA
| | - Christina Puchalski
- Department of Medicine and Health Sciences, The George Washington University's Institute for Spirituality and Health, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - William E Rosa
- Robert Wood Johnson Foundation Future of Nursing Program, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Hyer JM, Paredes AZ, Kelley EP, Tsilimigras D, Meyer B, Newberry H, Pawlik TM. Characterizing Pastoral Care Utilization by Cancer Patients. Am J Hosp Palliat Care 2020; 38:758-765. [PMID: 32799646 DOI: 10.1177/1049909120951082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To assess the rate of and characterize the utilization of pastoral care (PC) among patients on their cancer treatment trajectory. METHODS Patients included in the present study were diagnosed with cancer 01/2015-08/2019 at The Ohio State Wexner Medical Center-The James. To determine which patient demographic and clinical factors were independently associated with PC utilization, a multivariable logistic regression was performed. RESULTS A total of 14,322 patients were included in the study and 5,166 (36.1%) had at least one visit with PC. Cancers such as brain (n = 232, 4.5% vs. n = 159, 1.7%), liver/pancreas (n = 733, 14.2% vs. 686, 7.5%), and lung (n = 1,288 vs. 24.9% vs. n = 1,113, 12.2%) were more commonly noted among patients who utilized PC services (all p < 0.001). Furthermore, compared with patients diagnosed with Stage 1 cancer, patients with more advanced disease stages had higher odds of utilizing PC services (Stage III: OR 2.37, 95% CI 2.07-2.70; Stage IV OR 2.31, 95% CI: 2.04-2.61; both p < 0.05). Interestingly, patients who had a DNR order had a markedly higher odds (OR 4.18, 95%CI 3.76-4.65, p < 0.001) of utilizing PC services. DISCUSSION One in three patients with cancer utilized PC services. Patients with more severe prognoses and individuals with a DNR order were more likely to utilize PC. The data suggest that PC services are an important resource for many patients and should be integrated into the treatment approach for cancer.
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Affiliation(s)
- J Madison Hyer
- Department of Surgery, 2647The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Anghela Z Paredes
- Department of Surgery, 2647The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Elizabeth Palmer Kelley
- Department of Surgery, 2647The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Diamantis Tsilimigras
- Department of Surgery, 2647The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
| | - Bonnie Meyer
- 2647The Ohio State University Wexner Medical Center Department of Chaplaincy and Clinical Pastoral Education, OH, USA
| | - Hanci Newberry
- 2647The Ohio State University Wexner Medical Center Department of Chaplaincy and Clinical Pastoral Education, OH, USA
| | - Timothy M Pawlik
- Department of Surgery, 2647The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA
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Washington KT, Alaniz Staner LM, Collie BE, Craig KW, Demiris G, Oliver DP. Toward a Practice-Informed Agenda for Hospice Intervention Research: What Are Staff Members' Biggest Challenges? Am J Hosp Palliat Care 2020; 38:467-471. [PMID: 32757823 DOI: 10.1177/1049909120948222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The translation of evidence-based interventions into routine hospice care is impeded by numerous barriers, including a disconnect between research priorities and clinical care. To inform the development of a more practice-informed agenda for hospice intervention research, our team conducted a qualitative descriptive study, posing the following research questions: 1) How do hospice staff members describe their most significant work-related challenges? and 2) What regulatory changes do hospice staff members report would most improve hospice care? To answer these research questions, we interviewed 22 hospice staff members and then conducted a template analysis of the interview content. In doing so, we identified themes that described challenges in 5 key areas: time, documentation, professional roles, recruitment and retention, and burn-out. In addition, we identified a perceived need among hospice staff members for more regulatory flexibility and clarity. Based on our findings, we conclude that a practice-informed agenda for hospice intervention research includes the development and testing of interventions that increase efficiency, explicitly speak to the humanity of hospice care, and elevate the roles of all members of the interdisciplinary team.
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Affiliation(s)
- Karla T Washington
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA
| | - Leticia M Alaniz Staner
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA.,Supportive and Palliative Care Program, 14716University of Missouri Health Care, MO, USA
| | - Benjamin E Collie
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA.,Supportive and Palliative Care Program, 14716University of Missouri Health Care, MO, USA
| | - Kevin W Craig
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA.,Supportive and Palliative Care Program, 14716University of Missouri Health Care, MO, USA
| | - George Demiris
- Department of Biobehavioral Health Sciences, 6572University of Pennsylvania School of Nursing, PA, USA.,Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at the University of Pennsylvania, PA, USA
| | - Debra Parker Oliver
- Department of Family and Community Medicine, 14716University of Missouri School of Medicine, MO, USA
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Smigelsky MA, Jardin C, Nieuwsma JA, Brancu M, Meador KG, Molloy KG, Elbogen EB. Religion, spirituality, and suicide risk in Iraq and Afghanistan era veterans. Depress Anxiety 2020; 37:728-737. [PMID: 32248664 DOI: 10.1002/da.23013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/21/2020] [Accepted: 03/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND United States military veterans experience disproportionate rates of suicide relative to the general population. Evidence suggests religion and spirituality may impact suicide risk, but less is known about which religious/spiritual factors are most salient. The present study sought to identify the religious/spiritual factors most associated with the likelihood of having experienced suicidal ideation and attempting suicide in a sample of recent veterans. METHODS Data were collected from 1002 Iraq/Afghanistan-era veterans (Mage = 37.68; 79.6% male; 54.1% non-Hispanic White) enrolled in the ongoing Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center multi-site Study of Post-Deployment Mental Health. RESULTS In multiple regression models with stepwise deletion (p < .05), after controlling for depression and posttraumatic stress disorder (PTSD) diagnoses, independent variables that demonstrated a significant effect on suicidal ideation were perceived lack of control and problems with self-forgiveness. After controlling for age, PTSD diagnosis, and substance use problems, independent variables that demonstrated a significant effect on suicide attempt history were perceived as punishment by God and lack of meaning/purpose. CONCLUSIONS Clinical screening for spiritual difficulties may improve detection of suicidality risk factors and refine treatment planning. Collaboration with spiritual care providers, such as chaplains, may enhance suicide prevention efforts.
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Affiliation(s)
- Melissa A Smigelsky
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, North Carolina.,VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Healthcare System, Durham, North Carolina
| | - Charles Jardin
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Healthcare System, Durham, North Carolina
| | - Jason A Nieuwsma
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, North Carolina.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Mira Brancu
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Healthcare System, Durham, North Carolina.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Keith G Meador
- Mental Health and Chaplaincy, Department of Veterans Affairs, Durham, North Carolina.,Departments of Psychiatry and Preventative Medicine, Graduate Department of Religion, Center for Biomedical Ethics and Society, Vanderbilt University, Nashville, Tennessee
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- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Healthcare System, Durham, North Carolina
| | - Eric B Elbogen
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC), Durham Veterans Affairs Healthcare System, Durham, North Carolina.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
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Abstract
Hinduism is one of the five major world religions with >1 billion followers worldwide and encompasses a diversity of belief systems. As of 2010, an estimated 1.8 million Hindus lived in the United States, and this number is expected to increase to 4.8 million by 2050, making the United States home to the largest Hindu population outside of South Asia. As this population continues to grow, it will become increasingly important that clinicians of all disciplines develop a basic understanding of their beliefs and practices to address their palliative care needs. This article highlights 10 considerations for Hindu patients and their families relevant to inpatient care, symptom management, and advance care planning.
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Affiliation(s)
- Rushil V Patel
- Supportive Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Viraj R Patel
- The University of Chicago Divinity School, Chicago, Illinois, USA
| | | | - Arif H Kamal
- Duke Cancer Institute, Duke Fuqua School of Business, Durham, North Carolina, USA
| | - Judith E Nelson
- Supportive Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Critical Care Service, Department of Anesthesia and Critical Care, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Weill Cornell Medical College, New York, New York, USA
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38
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Gordon CS, Jones SC, Taylor M, McInerney M, Wegener J. An Australian study on the benefits of pastoral care to aged care residents in Christian affiliated homes. Health Soc Care Community 2020; 28:366-375. [PMID: 31588645 DOI: 10.1111/hsc.12868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 09/05/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
This study aimed to understand the experience of pastoral care (PC), that is, the provision of support, comfort and spiritual counselling, from the perspective of Australian aged care residents. A survey research design captured feedback on participants' PC experience. Outcomes were reported by 575 residents (aged 53-102) across 41 sites. The majority perceived that they received a high quality of care (92%) and benefited from their meeting with the pastoral practitioner (80%), 'often' or 'all of the time'. A few significant differences were found based on participants' gender, spirituality (i.e. connection and meaning), religiosity (i.e. faith beliefs and religious practices) and well-being. Females and participants who identified as both religious and spiritual were more likely to feel that their faiths/beliefs were valued. Those with greater psychological well-being, as defined by the World Health Organisation (1998), were more likely to report receiving a high quality of care and greater benefits from receiving PC than those with poorer well-being. Three overarching themes and eight subthemes were identified from the open-ended responses: 1) personal qualities of the pastoral practitioner; caring, supportive, understanding and empathetic; 2) pastoral practitioner met specific needs; spiritual and religious, friendship and company and assistance, advice and help; and 3) positive impact on the participant; feeling listened to, peaceful and valued, accepted and respected. The qualitative findings resonate with Maslow's Hierarchy of Needs, to feel safe, belong and have self-esteem. There was a synergy between what participants desire in the care they receive, as expressed in the open-ended questions, and what the pastoral practitioners provide, as indicated in the quantitative findings. A study strength was its mixed-method, multi-site and cross-organisational context, enabling PC to be explored across a diverse sample. Future research should consider a pre- and post-test survey to more comprehensively capture the impact and benefits of PC.
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Dekker J, de Groot V, Ter Steeg AM, Vloothuis J, Holla J, Collette E, Satink T, Post L, Doodeman S, Littooij E. Setting meaningful goals in rehabilitation: rationale and practical tool. Clin Rehabil 2019; 34:3-12. [PMID: 31530186 DOI: 10.1177/0269215519876299] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CONTEXT Goal-setting is a key characteristic of modern rehabilitation. However, goals need to be meaningful and of importance to the client. AXIOMS Both theories and empirical evidence support the importance of a hierarchy of goals: one or more overall goals that clients find personally meaningful and specific goals that are related to the overall goals. We posit that the client's fundamental beliefs, goals and attitudes ("global meaning") need to be explored before setting any rehabilitation goal. A chaplain or other person with similar skills can be involved in doing so in an open-ended way. The client's fundamental beliefs, goals and attitudes serve as a point of departure for setting rehabilitation goals. SETTING GOALS We set out a three-stage process to set goals: (1) exploring the client's global meaning (i.e. fundamental beliefs, goals and attitudes), (2) deriving a meaningful overall rehabilitation goal from the client's global meaning and (3) setting specific rehabilitation goals that serve to achieve the meaningful overall rehabilitation goal. CONCLUSION This is an extension of current practice in many rehabilitation teams, which may help counter the drive toward exclusively functional goals based around independence.
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Affiliation(s)
- Joost Dekker
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Vincent de Groot
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | | | - Jasmijn Holla
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
| | - Emma Collette
- Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Ton Satink
- Department of Occupational Therapy and Research Group Neurorehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Lenneke Post
- Department of Spiritual Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands.,Faculty of Religion and Theology, VU University, Amsterdam, The Netherlands
| | - Suzan Doodeman
- Department of Rehabilitation Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Elsbeth Littooij
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands
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Abstract
At present, the field of chaplaincy does not have a standardized vocabulary for the activities that chaplains conduct in different institutions and settings. This is a hindrance when making comparisons among various chaplain activities across institutions and drawing conclusions from the data reported. Recently a standardized vocabulary, the Advocate Taxonomy, was developed by a group of chaplains and there was consensus agreement that the taxonomy represented the gamut of chaplain activities. However, to date, no data with adults has been presented to support the conclusions reached by the taxonomy development team. This article is the first effort to examine which taxonomy items are most commonly used in the acute care setting. It further explores the differences in the use of the taxonomy items in different settings (ICU vs. Non-ICU), the type of chaplain visit (Initial vs. Follow-up) and the patient's discharge status (Expired vs. discharged alive).
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Affiliation(s)
- Vanshdeep Sharma
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah B Marin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaobo Zhong
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Madhu Mazumdar
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maggie Keogh
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zorina Costello
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lina Jandorf
- Center for Behavioral Oncology, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Wada RK, Wong L, Flohr A, Kurahara D, Arndt R, Deutsch MJ, Ing D, Richardson K, Munro A, Kaneshige L, Mullis M, Hatae M, Albright CL. Engaging a Community Chaplaincy Resource for Interprofessional Health Care Provider Training in Facilitating Family Decision Making for Children at End-of-Life. Hawaii J Med Public Health 2019; 78:37-40. [PMID: 31285967 PMCID: PMC6603893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Coordinating the care of terminally ill children is difficult for both parents and the health care team. An underutilized resource is spiritual care, such as that provided by Pacific Health Ministry, a community-based nonprofit established to develop hospital ministry training programs in Hawai'i and provide chaplaincy services to local facilities. This paper describes a training exercise, called the Pediatric Interprofessional Program (PIPP), which is modeled after an adult program, the Hawai'i Interprofessional Training for End of Life Communication in the intensive care unit (HITEC-ICU). Both programs were developed to introduce teams of learners consisting of Pacific Health Ministry spiritual care residents, internal medicine or pediatric residents, undergraduate students in nursing, and graduate students in social work to techniques in delivering serious, life-altering information, and the dynamics of working as an interprofessional team through use of progressively unfolding clinical simulations. PIPP facilitators included chaplaincy instructors at Pacific Health Ministry, university faculty, and community practitioners in pediatrics, nursing, and social work. The simulations were conducted at the Translational Health Science Simulation Center (THSSC) of the University of Hawai'i at Mānoa (UHM) School of Nursing and Dental Hygiene (SONDH), with simulated patients from the HealthCAST (Collaborative Acting Simulation Training) program, a collaborative agreement between SONDH and the UHM Department of Theatre and Dance. The training is ongoing, but has thus far demonstrated that interprofessional education programs are feasible across community, academic, and clinical lines, and benefit from the engagement of community resources.
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Affiliation(s)
- Randal K Wada
- School of Nursing and Dental Hygiene, Department of Nursing, University of Hawai'i at Mānoa, Honolulu, HI (RKW, LW, MJD, DI, KR, CLA)
- Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI (RKW, DK)
- Pediatric Blood and Cancer Center, Kapi'olani Medical Center for Women & Children, Honolulu, HI (RKW, LK, MM, MH)
| | - Lorrie Wong
- School of Nursing and Dental Hygiene, Department of Nursing, University of Hawai'i at Mānoa, Honolulu, HI (RKW, LW, MJD, DI, KR, CLA)
- Translational Health Science Simulation Center, School of Nursing and Dental Hygiene,University of Hawai'i at Mānoa, Honolulu, HI (LW, AF, RA, MJD, DI, KR, AM)
| | | | | | - Robin Arndt
- Myron B. Thompson School of Social Work, University of Hawai‘i at Mānoa,
Honolulu, HI
| | - Melodee J Deutsch
- School of Nursing and Dental Hygiene, Department of Nursing, University of Hawai'i at Mānoa, Honolulu, HI (RKW, LW, MJD, DI, KR, CLA)
- Translational Health Science Simulation Center, School of Nursing and Dental Hygiene,University of Hawai'i at Mānoa, Honolulu, HI (LW, AF, RA, MJD, DI, KR, AM)
| | - Dana Ing
- Neonatal Intensive Care Unit, Kapi‘olani Medical Center for Women & Children,
Honolulu, HI
| | - Karol Richardson
- School of Nursing and Dental Hygiene, Department of Nursing, University of Hawai'i at Mānoa, Honolulu, HI (RKW, LW, MJD, DI, KR, CLA)
- Translational Health Science Simulation Center, School of Nursing and Dental Hygiene,University of Hawai'i at Mānoa, Honolulu, HI (LW, AF, RA, MJD, DI, KR, AM)
| | - Alexander Munro
- Department of Theatre and Dance, College of Arts and Humanities, University of
Hawai‘i at Mānoa, Honolulu, HI
| | - Lori Kaneshige
- Pediatric Blood and Cancer Center, Kapi'olani Medical Center for Women & Children, Honolulu, HI (RKW, LK, MM, MH)
| | - Mary Mullis
- Pediatric Blood and Cancer Center, Kapi'olani Medical Center for Women & Children, Honolulu, HI (RKW, LK, MM, MH)
| | - Mychal Hatae
- Pediatric Blood and Cancer Center, Kapi'olani Medical Center for Women & Children, Honolulu, HI (RKW, LK, MM, MH)
| | - Cheryl L Albright
- Office of Public Health Studies, Myron B. Thompson School of Social Work, University
of Hawai‘i at Mānoa, Honolulu, HI
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Fleenor D, Terry K, Sharma V, Marin D. Prevalence of Journal Clubs: A Survey of Clinical Pastoral Education Residencies in the United States. J Health Care Chaplain 2019; 26:72-86. [PMID: 30915919 DOI: 10.1080/08854726.2019.1582210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Journal clubs are an established and effective method of promoting research literacy and evidence-based practice in the medical field. However, their use in clinical pastoral education (CPE) residencies is relatively new and largely unstudied. In 2016 we surveyed 201 ACPE certified educators of CPE residency programs throughout the United States. Eighty-eight certified educators participated in this first-of-its-kind study. Our aim was to determine the prevalence and structure of existing CPE journal clubs and establish baseline data to determine the effectiveness of future programs for increasing research literacy. Seventy-three percent of respondents indicated they did not have a journal club. Journal clubs that do exist tend to meet at least monthly and last one to two hours. Chaplains, certified educators, or chaplain residents lead the majority of journal clubs. Seventy percent of respondents whose programs had journal clubs indicated they were interested to learn more about journal clubs. Journal clubs do not appear to be common in CPE residencies and chaplains may feel unprepared to lead them. CPE journal clubs would likely be strengthened by collaboration with other disciplines and from additional training for CPE certified educators. We offer suggestions to this end as well as areas for further research.
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Affiliation(s)
- David Fleenor
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Karen Terry
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vanshdeep Sharma
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Deborah Marin
- Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Abstract
Delivering comprehensive end-of-life care to dying patients must involve addressing physical symptoms and psychosocial concerns. Care pathways have been introduced to support health care teams in delivering this care. This retrospective chart review explores the contributions of the Spiritual Care Team in the care of dying patients. They offer a range of interventions which include supportive care, religious and spiritual support. This study was one step towards appreciating the contributions of the Spiritual Care Team.
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Affiliation(s)
- Kalli Stilos
- Sunnybrook Health Science Centre, Canada; Adjunct Clinical Faculty, University of Toronto, Lawrence Bloomberg Faculty of Nursing, Canada
| | - Bill Ford
- Sunnybrook Health Sciences Centre, Canada
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Damen A, Labuschagne D, Fosler L, O'Mahony S, Levine S, Fitchett G. What Do Chaplains Do: The Views of Palliative Care Physicians, Nurses, and Social Workers. Am J Hosp Palliat Care 2018; 36:396-401. [PMID: 30336692 DOI: 10.1177/1049909118807123] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
It is well accepted that attention to spiritual concerns is a core dimension of palliative care. It is similarly well accepted that chaplains are the spiritual care specialists who should address such concerns. However, what chaplains do when they provide care for patients and families is often poorly understood by their palliative care colleagues. Having a clear understanding of what chaplains do is important because it contributes to improved utilization of the spiritual care and other resources of the palliative care team and thereby to better care for patients and families. The aim of this study was to describe what palliative care physicians, nurses, and social workers understand about what chaplains do. Brief surveys were distributed to participants at 2 workshops for palliative care professionals in 2016. The survey was completed by 110 participants. The majority reported that they understood what chaplains do moderately well or very well. Thirty-three percent of the written comments about what chaplains do were very general; 25% were more specific. Only a small proportion of the participants were aware that chaplains provide care for the team, are involved in facilitating treatment decision-making, perform spiritual assessments, and bridge communication between the patient/family/team/community. Based on our survey, palliative care colleagues appear to have a broad understanding of what chaplains do but many may be unfamiliar with important contributions of chaplains to care for patients, families, and teams. These findings point to the need for ongoing education of palliative teams about what chaplains do in palliative care.
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Affiliation(s)
- Annelieke Damen
- 1 Care Ethics, University of Humanistic Studies, Utrecht, The Netherlands
| | - Dirk Labuschagne
- 2 School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Laura Fosler
- 3 College of Nursing, Section of Palliative Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Sean O'Mahony
- 4 Palliative Care, Rush University Medical Center, Chicago, IL, USA
| | | | - George Fitchett
- 6 Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA
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45
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Abstract
AIM To determine the responsiveness of primary care chaplaincy (PCC) to the current variety of presenting symptoms seen in primary care. This was done with a focus on complex and undifferentiated illness. BACKGROUND Current presentations to primary care are often complex, undifferentiated and display risk factors for social isolation and loneliness. These are frequently associated with loss of well-being and spiritual issues. PCC provides holistic care for such patients but its efficacy is unknown in presentations representative of such issues. There is therefore a need to assess the characteristics of those attending PCC. The effectiveness of PCC relative to the type and number of presenting symptoms should also be analysed whilst evaluating impact on GP workload. METHODS This was a retrospective observational study based on routinely collected data. In total, 164 patients attended PCC; 75 were co-prescribed antidepressants (AD) and 89 were not (No-AD). Pre- and post-PCC well-being was assessed by the Warwick-Edinburgh mental well-being score. Presenting issue(s) data were collected on a separate questionnaire. GP appointment utilisation was measured for three months pre- and post-PCC. FINDINGS Those displaying undifferentiated illness and risk factors for social isolation and loneliness accessed PCC. PCC (No-AD) was associated with a clinically meaningful and statistically significant improvement in well-being in all presenting issues. This effect was maintained in those with multiple presenting issues. PCC was associated with a reduction in GP appointment utilisation in those not co-prescribed AD.
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Ragsdale JR, Othman M, Khoury R, Dandoy CE, Geiger-Behm K, Mueller M, Mussallam E, Davies SM. Islam, The Holy Qur'an, and Medical Decision-Making: The Experience of Middle Eastern Muslim Families with Children Undergoing Bone Marrow Transplantation in the United States. J Pastoral Care Counsel 2018; 72:180-189. [PMID: 30231824 DOI: 10.1177/1542305018797313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Some Arabic-speaking Muslim family members of children requiring bone marrow transplantation receive medical care for their children in the United States. Muslim family members' use of Islam in the course of their child's bone marrow transplantation was studied using grounded theory, a qualitative research method. Eighteen members of Middle Eastern Muslim families with a total of 13 children receiving bone marrow transplantation were interviewed by an Arabic-speaking healthcare provider. Interviews were coded by an interdisciplinary team. Seven key themes were identified.
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Affiliation(s)
| | | | - Ruby Khoury
- Cincinnati Children's Hospital Medical Center, OH, USA
| | | | | | - Mark Mueller
- Cincinnati Children's Hospital Medical Center, OH, USA
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O'Callaghan C, Byrne L, Cokalis E, Glenister D, Santilli M, Clark R, McCarthy T, Michael N. "Life Within the Person Comes to The Fore": Pastoral Workers' Practice Wisdom on Using Arts in Palliative Care. Am J Hosp Palliat Care 2017; 35:1000-1008. [PMID: 29284277 DOI: 10.1177/1049909117748881] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Pastoral care (also chaplaincy, spiritual care) assists people to find meaning, personal resources, and connection with self, others, and/or a higher power. Although essential in palliative care, there remains limited examination of what pastoral workers do. This study examined how pastoral workers use and consider the usefulness of art-based modalities. METHODS Qualitative research was used to examine the practice wisdom (tacit practice knowledge) of pastoral workers experienced in using visual arts and music in palliative care. Two focus groups were conducted. Thematic analysis was informed by grounded theory. RESULTS Six pastoral workers shared information. Three themes emerged. First, pastoral workers use arts as "another tool" to extend scope of practice by assisting patients and families to symbolically and more deeply contemplate what they find "sacred." Second, pastoral workers' art affinities inform their aims, assessments, and interactions. Third, pastoral workers perceive that art-based modalities can validate, enlighten, and transform patients and families through enabling them to "multisensorially" (through many senses) feel recognized, accepted, empowered, and/or close to God. Key elements involved in the work's transformative effects include enabling beauty, ritual, and the sense of "home" being heard, and legacy creation. DISCUSSION AND CONCLUSION Pastoral workers interpret that offering art-based modalities in palliative care can help patients and families to symbolically deal with painful memories and experiences, creatively engage with that deemed significant, and/or encounter a sense of transcendence. Training in generalist art-based care needs to be offered in pastoral education.
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Affiliation(s)
- Clare O'Callaghan
- 1 Department of Palliative and Supportive Care Research, Cabrini Health Australia, Malvern, Victoria, Australia.,2 Departments of Psychosocial Cancer Care and Medicine, St Vincent's Hospital, Melbourne, The University of Melbourne, Melbourne, Victoria, Australia.,3 Institute for Ethics and Society, The University of Notre Dame, Sydney, Australia
| | - Libby Byrne
- 4 School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,5 Whitley College, The University of Divinity, Melbourne, Australia
| | - Eleni Cokalis
- 6 Creative Arts Pastoral Care, Caritas Christi Hospice, St Vincent's Hospital, Melbourne, Australia
| | - David Glenister
- 7 Pastoral/Spiritual Care, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Margaret Santilli
- 8 Pastoral Care, Epworth Freemasons, East Melbourne, Victoria, Australia
| | - Rose Clark
- 9 Pastoral/Spiritual Care, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Therese McCarthy
- 10 Pastoral Care, Caritas Christi Hospice, St Vincent's Hospital, Melbourne, Australia
| | - Natasha Michael
- 1 Department of Palliative and Supportive Care Research, Cabrini Health Australia, Malvern, Victoria, Australia.,11 School of Medicine, The University of Notre Dame, Sydney, Australia.,12 Faculty of Medicine, Nursing and Health Sciences, Monash Health, Melbourne, Australia
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48
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Abstract
Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients' spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU. We review evidence demonstrating the benefits of, and persistent unmet needs for, spiritual care services, as well as the current state of spiritual care delivery in the ICU setting. Furthermore, we outline tools and strategies intensivists and other critical care medicine health-care professionals can employ to support the spiritual well-being of patients and families, with a special focus on chaplaincy services.
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Affiliation(s)
- Jim Q Ho
- 1 Middlebury College, Middlebury, VT, USA.,2 Pulmonary Section, Medical Service, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Christopher D Nguyen
- 2 Pulmonary Section, Medical Service, VA Palo Alto Health Care System, Palo Alto, CA, USA.,3 Division of Pulmonary and Critical Care Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Richard Lopes
- 4 Chaplain Service, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Stephen C Ezeji-Okoye
- 5 Division of General Medical Disciplines, Stanford University, Stanford, CA, USA.,6 Director's Office, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Ware G Kuschner
- 2 Pulmonary Section, Medical Service, VA Palo Alto Health Care System, Palo Alto, CA, USA.,3 Division of Pulmonary and Critical Care Medicine, School of Medicine, Stanford University, Stanford, CA, USA
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49
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Abstract
The use of story, and the use of art or various arts-based techniques have become popular in a number of helping professions, including spiritual care. There remains a gap in the literature, however, in which an approach comprised of both story and art or objects is explored. This paper addresses this gap by discussing the experience, theory, benefits, and technique of combining story and art or object-based techniques for the provision of spiritual care.
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Affiliation(s)
- Aaron P B Smith
- Emmanuel Bible College, Canada Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Canada
| | - Julia E Read
- Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Canada
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50
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Macdonald G. The efficacy of primary care chaplaincy compared with antidepressants: a retrospective study comparing chaplaincy with antidepressants. Prim Health Care Res Dev 2017; 18:354-65. [PMID: 28414013 DOI: 10.1017/S1463423617000159] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Aim To determine the effectiveness of primary care chaplaincy (PCC) when used as the sole intervention, with outcomes being compared directly with those of antidepressants. This was to be carried out in a homogenous study population reflective of certain demographics in the United Kingdom. BACKGROUND Increasing numbers of patients are living with long-term conditions and 'modern maladies' and are experiencing loss of well-being and depression. There is an increasing move to utilise non-pharmacological interventions such as 'talking therapies' within this context. Chaplaincy is one such 'talking therapy' but within primary care its evidence base is sparse with only one quantitative study to date. There is therefore a need to evaluate PCC excluding those co-prescribed antidepressants, as this is not evidenced in the literature as yet. PCC also needs to be directly compared with the use of antidepressants to justify its use as a valid alternative treatment for loss of well-being and depression. METHODS This was a retrospective observational study based on routinely collected data. There were 107 patients in the PCC group and 106 in the antidepressant group. Socio-demographic data were collected. Their pre- and post-intervention (either chaplaincy or antidepressant) well-being was assessed, by the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) which is a validated Likert scale. Findings The majority of both groups were female with both groups showing marked ethnic homogeneity. PCC was associated with a significant and clinically meaningful improvement in well-being at a mean follow-up of 80 days. This treatment effect was maintained after those co-prescribed antidepressants were removed. PCC was associated with an improvement in well-being similar to that of antidepressants with no significant difference between the two groups.
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