Journal of Health Care Chaplaincy最新文献

The transition from inpatient spiritual care to spiritual care in outpatient, community or primary care settings presents various challenges to chaplains. We have examined how chaplaincy organizations navigate different types of pluralism to find their function and position in these settings. Secondary analysis was performed on 37 thick descriptions of chaplaincy organizations, focus group discussions with three of these organizations, and 24 client questionnaires. The results show that the organizations have to navigate religious pluralism, pluralism in health care professions, and pluralism in patient populations with their associated variety in financial arrangements. Therefore, the chaplains adjust their activities to the care landscape present in their region. They also adjust their communication style to the understanding of spirituality and the communication style of the care profession and financers they are in contact with. Through showing themselves and their work, they slowly build trust, durable working relationships, and a broader profile.

Spiritual beliefs are increasingly important toward the end-of-life as they shape perspectives on good care, life, and death. However, in pluralistic societies, the spiritual beliefs of patients and care providers may differ. Care providers can find it difficult to be responsive to spiritual diversity and to how different belief systems of patients and their families may influence perspectives on care and dying. This can lead to moral challenges. Dialogical clinical ethics support (CES) helps care providers to jointly reflect on and deal with moral challenges. However, while spirituality shapes perspectives on good care, it is rarely addressed explicitly in CES sessions. We interviewed ten spiritual counselors of different denominations in The Netherlands to explore spirituality-related moral challenges in the delivery of palliative care, and to gain insight into their perspectives on what is needed to make both dialogues with patients and family and dialogical CES more responsive to spiritual diversity.

Health personnel may seek chaplain support to discuss stressors related to complex patient cases, difficult team dynamics, and personal issues. In this survey study of 1376 healthcare interprofessional clinicians, participants reported interacting with chaplains most frequently over patient-related stressors in the prior 12 months. Factors associated with chaplain interactions to discuss all three stressors included: reporting chaplains provide spiritual support to health personnel, more years of service, seeking professional help to deal with stressors, and higher levels of secondary traumatic stress. Being a registered nurse (RN) and working in a critical care specialty were associated with increased odds of interactions with a chaplain to discuss patient-related stressors while identifying as Catholic or Protestant was associated with chaplain interactions to discuss team-related and personal stressors. Chaplains should tailor interventions to promote health personnel's spiritual well-being based on patient-related, team-related, and personal stressors. Healthcare institutions which do not employ chaplains should advocate for this resource. Leaders in healthcare settings with chaplains should promote increased staff awareness that chaplains are available to support wellbeing by discussing patient, team, or personal stressors.

This qualitative study explores how geriatric inpatients (n = 103) experience a one-on-one chaplaincy visit. Although some patients expressed neutral or negative feelings about the chaplaincy visit, the large majority spoke in a very positive way about the chaplain's care. Using thematic analysis, we identified four main themes characterizing patients' experiences with chaplaincy visits. (1) Patients experienced the chaplaincy visit as a place to tell personal stories and express their religious beliefs. (2) They had a safe and trusting relationship with the chaplain. (3) The interaction with the chaplain brought new perspectives. (4) After the visit, they felt satisfied, relieved, peaceful, and strong. This study demonstrates that the experiences of geriatric patients contribute to a better understanding of the value of chaplaincy care. Integrating patients' perspectives on chaplaincy care is recommended, both in future research and healthcare chaplaincy.

This first-of-its-kind study explored the essential competencies healthcare chaplaincy hiring managers (HCHMs) sought for entry-level healthcare chaplains (HCCs). We conducted qualitative interviews with 16 HCHMs and using reflexive thematic analysis (RTA), developed nine key themes: interpersonal skills, teamwork, knowledge of family and group dynamics, understanding of the healthcare system, professionalism, proficiency in spiritual assessment, effective communication, commitment to lifelong learning, and knowledge of various religious and spiritual beliefs, extending beyond one's own faith tradition. These themes reflected HCCs roles as healthcare professionals who contribute to patient care, interdisciplinary collaboration, and spiritual leadership responsibilities. The study underscored the need for chaplaincy education to integrate healthcare-specific coursework, interprofessional training, cultural and religious humility, and deeper knowledge of diverse belief systems. Developing and incorporating curriculum standards based on these themes could enhance the readiness of HCCs to deliver comprehensive care and meet the dynamic demands of diverse patient populations within today's healthcare landscape.

This is a descriptive, quantitative, cross-sectional study of how ACPE Certified Educators (CEs) allocated their time among varied responsibilities in calendar year 2021. Using a structured interview assisted survey instrument, 25 CEs at academic medical centers/university teaching hospitals were surveyed via Zoom/Phone. Results found a median commitment of 58% of time on clinical pastoral education (CPE) activities (38% to teaching and 20% to administration). CEs (7) who also serve as Spiritual Care Department directors/managers spent 45% on CPE and 30% on department activities. Sixteen of the CEs strongly or somewhat agreed that CE involvement in direct patient/family/staff care was important, yet median CE involvement in such care was 5%. Future studies should examine CE time commitment levels in a broader sample of ACPE accredited institutions.

In addition to supporting patients and their loved ones at critical times, chaplains have long understood that caring for their health care colleagues is an important part of their practice. The Covid-19 pandemic prompted conversations among chaplains about how best to address the stress they were observing in health care workers. Our team conducted a scoping review in PubMed and CINAHL of peer reviewed literature describing chaplaincy care for health care workers. We started with 364 unique articles and found 59 that met criteria for the review. Five themes surfaced in analysis of these articles, with two themes emerging as most important: (1) descriptions of care for staff as part of the chaplain's role, especially when staff are making difficult decisions and (2) reports of the effects of chaplain care for staff, both indirect and direct. We discovered that research was limited, and more research is needed regarding chaplain care for health care colleagues.

The complexity of patient care demands that health care teams collaborate effectively. This means that when pastoral care staff engage with patients, they need to communicate their findings to other members of the multidisciplinary team to maximize patient benefits. In 2016, an Australian hospital found that pastoral care staff were able to visit only 30% of admitted patients, and that documentation of pastoral care visits was minimal. This paper describes and measures the impact of a quality improvement education program for pastoral care workers by auditing patient medical records pre- and post-intervention. The intervention did not significantly increase the number of pastoral care visits or referrals. Documentation of pastoral care visits was significantly improved in terms of the detail provided. More work is required to standardize indications for pastoral care referral and templates for pastoral documentation in patient medical records.

The Veterans Health Administration (VHA) offers spiritual supports to Veterans nationally through its Chaplaincy Service and its Whole Health initiative. There are no systematic efforts to extend spiritual supports to Veterans re-entering community post-incarceration, however. Thus, the full potential of spiritual supports in bolstering well-being and minimizing recidivism during re-entry may not be fully realized. To explore this potential and ways to optimize it for re-entry Veterans, we conducted an exploratory needs assessment. We interviewed six re-entry Veterans and six staff members who work in re-entry to explore perceived spiritual needs in re-entry and ways to address such needs; we analyzed interview data thematically. Several themes emerged: 1) Spirituality as pluralistic; 2) Positive impacts of spirituality; 3) Tensions around the immediacy of spiritual needs; 4) Current spiritual supports and their limitations; and 5) Suggested improvements. We propose initiatives which VHA might pursue to verify and support re-entry Veterans' spiritual needs.

Caregivers of children with medical complexity face daily tasks comparable to pediatric critical care nursing with multiple stressors. This may result in emotional and spiritual distress. Caregivers may also rely on their religion and spirituality to cope. Chaplains have the potential to support caregivers in this setting, beginning with spiritual assessment. This study's purpose was to verify the feasibility and acceptability of the Spiritual Care Assessment and Intervention framework adapted for home-based chaplaincy with caregivers of children receiving home mechanical ventilation (SCAI-Peds). A quasi-experimental, proof-of-concept trial with N = 6 caregivers and two board certified chaplains was carried out. SCAI-Peds was acceptable and feasible to caregivers, delivered with high fidelity, and was also acceptable to the chaplains. Home-based intervention delivery may provide more room for reflection and reframing than acute care settings. The results warrant advancing SCAI-Peds beyond the pilot stage.