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Chaplains' reports of integration in community health initiatives: a qualitative study. 牧师对融入社区健康计划的报告:一项定性研究。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-09-18 DOI: 10.1080/08854726.2024.2401742
Kelsey B White, Paul Galchutt, Khanya Collier, Csaba Szilagyi, George Fitchett

Health care and religious organizations have a long history with one another. Chaplains' investments in the health and wellbeing of their local communities have extended beyond the hospital walls for longer than many chaplains may recognize. However, the published evidence suggests these efforts have been limited. Given the history of health care evolution in the United States, the small evidence of cases highlighting chaplains' leadership within community health initiatives, and the pressure for health systems to address the social determinants of health, we sought to explore chaplains' integration in community health and wellness initiatives. This paper presents the results of a qualitative analysis of interviews with chaplains working to promote community health and wellness (n = 10). The identified themes highlight factors at the individual chaplain level, such as how chaplains got involved, characteristics of the chaplains' contexts, and the impact of chaplains' involvement.

医疗保健和宗教组织之间有着悠久的历史渊源。牧师们对当地社区健康和福祉的投入已经超越了医院的围墙,其时间之长可能超出了许多牧师的认知范围。然而,公开发表的证据表明,这些努力是有限的。考虑到美国医疗保健发展的历史、牧师在社区健康计划中发挥领导作用的少量案例,以及医疗系统在解决健康的社会决定因素方面所面临的压力,我们试图探索牧师在社区健康和幸福计划中的融入情况。本文介绍了对致力于促进社区卫生与健康的牧师(n = 10)进行访谈的定性分析结果。确定的主题突出了牧师个人层面的因素,如牧师如何参与、牧师背景的特点以及牧师参与的影响。
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引用次数: 0
Essential competencies for healthcare chaplains: insights from hiring managers and implications for chaplaincy education. 医疗保健牧师的基本能力:招聘经理的见解和对牧师教育的影响。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-09-09 DOI: 10.1080/08854726.2024.2399464
David W Fleenor, Beth L Muehlhausen, Cate Michelle Desjardins, George Fitchett

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.

这项同类研究首次探讨了医疗保健牧师招聘经理(HCHMs)希望入门级医疗保健牧师(HCCs)具备的基本能力。我们对 16 名医疗保健牧师进行了定性访谈,并利用反思性主题分析 (RTA) 提出了九个关键主题:人际交往技能、团队合作、对家庭和团体动态的了解、对医疗保健系统的理解、专业精神、精通灵性评估、有效沟通、致力于终身学习,以及对各种宗教和灵性信仰的了解(超越自身信仰传统)。这些主题反映了圣职人员作为医疗保健专业人员在病人护理、跨学科合作和精神领导责任方面的作用。研究强调,牧师教育需要整合医疗保健专业课程、跨专业培训、文化和宗教谦逊以及对不同信仰体系的深入了解。根据这些主题制定并纳入课程标准,可提高保健中心提供全面护理的准备程度,并满足当今医疗保健环境中不同患者群体的动态需求。
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引用次数: 0
Factors associated with health personnel-chaplain interactions in the hospital setting: a cross-sectional survey study. 医院环境中医护人员与牧师互动的相关因素:一项横断面调查研究。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-09-03 DOI: 10.1080/08854726.2024.2393551
Teresa Rangel, Gary Weisbrich, Sarah Sumner, Adam Gaines, Robert Leavitt

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.

医务人员可能会寻求牧师的支持,以讨论与复杂的患者病例、困难的团队动态和个人问题相关的压力。在这项针对 1376 名医疗保健跨专业临床医生的调查研究中,参与者表示在过去 12 个月中最常就与患者相关的压力问题与牧师进行互动。与牧师互动讨论所有三种压力相关的因素包括:报告牧师为医护人员提供精神支持、服务年限较长、寻求专业帮助以应对压力以及继发性创伤压力水平较高。注册护士(RN)和在重症监护专业工作与增加与牧师互动讨论患者相关压力的几率有关,而天主教徒或新教徒身份与牧师互动讨论团队相关压力和个人压力有关。牧师应根据与患者相关、团队相关和个人相关的压力因素,采取针对性的干预措施,促进医务人员的精神健康。未聘用牧师的医疗机构应倡导这一资源。有牧师的医疗机构的领导者应提高员工的认识,让他们知道牧师可以通过讨论患者、团队或个人压力来支持他们的健康。
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引用次数: 0
Geriatric inpatients' experiences with one-on-one chaplaincy visits in Belgium. 比利时老年住院病人对一对一牧师探访的体验。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-19 DOI: 10.1080/08854726.2024.2386873
Lindsy Desmet, Jessie Dezutter, Anne Vandenhoeck, Annemie Dillen

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.

本定性研究探讨了老年住院病人(n = 103)如何体验一对一的牧师探访。虽然有些患者对牧师探访表示了中性或负面的感受,但绝大多数患者对牧师的护理给予了非常积极的评价。通过主题分析,我们确定了病人对牧师探访经历的四大主题。(1) 病人将牧师探访视为讲述个人故事和表达宗教信仰的场所。(2) 他们与牧师建立了安全和信任的关系。(3) 与牧师的互动带来了新的视角。(4) 探访结束后,他们感到满意、宽慰、平静和坚强。这项研究表明,老年病人的经历有助于更好地理解院牧关怀的价值。建议在未来的研究和医疗护理牧师工作中结合病人对牧师护理的看法。
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引用次数: 0
A time study of ACPE certified educators. 对 ACPE 认证教育工作者的时间研究。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-08-09 DOI: 10.1080/08854726.2024.2388455
Christy Howard-Steele, Alexander Tartaglia, Janet L Hanson, George Fitchett

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.

这是一项描述性、定量、横断面研究,研究 2021 年 ACPE 认证教育工作者(CEs)如何在各种职责中分配时间。采用结构化访谈辅助调查工具,通过 Zoom/Phone 对学术医疗中心/大学教学医院的 25 名认证教育者进行了调查。结果发现,临床教牧教育(CPE)活动投入的时间中位数为 58%(38% 用于教学,20% 用于行政管理)。同时担任灵性关怀部门主任/经理的 CEs(7 位)有 45% 的时间用于 CPE,30% 的时间用于部门活动。16 位 CE 非常同意或比较同意 CE 参与患者/家属/员工的直接护理非常重要,但 CE 参与此类护理的中位数为 5%。未来的研究应在更广泛的 ACPE 认证机构样本中考察 CE 的时间投入水平。
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引用次数: 0
Self-described religious and spiritual identities of patients receiving gender-affirming surgeries: Implications for chaplaincy practice. 接受性别确认手术的患者自述的宗教和精神身份:对牧师实践的影响。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-07-25 DOI: 10.1080/08854726.2024.2379710
Alyxandra Ramsay, Jabe Ziino, Jo Hirschmann

Studies of the U.S. population in general and transgender and gender diverse (TGD) communities specifically suggest that religion and spirituality (R/S) can function in both positive and negative ways, including on health outcomes. Patients recovering from gender-affirming surgeries were asked by chaplains, during the course of spiritual care visits, to describe their R/S identities in their own words. Seventy-five responses were included in the study and were coded. Six themes and 10 sub-themes were identified. The themes were (1) centeredness in self; (2) transcendent belief system; (3) non-religious belief systems; (4) importance of prayer; (5) R/S identity and practice as fixed and consistent; and (6) R/S identity and practice as flexible, contextual, and transforming. The findings broadly reflected national data about R/S belonging, including trends related to the growing share of the population that identifies as atheist, agnostic, or spiritual but not religious; ambivalent relationships with R/S communities due to transphobia; and R/S beliefs and practices as supportive. Implications for chaplaincy practice are discussed, including the need for chaplains to understand both demographic trends and the intersections of R/S and transphobia.

对美国一般人群以及变性人和性别多元化(TGD)群体的研究表明,宗教和灵性(R/S)既可以发挥积极作用,也可以发挥消极作用,包括对健康结果的影响。在精神关怀探访过程中,牧师要求从性别确认手术中康复的患者用自己的话描述他们的 R/S 身份。有 75 份回答被纳入研究并进行了编码。研究确定了六个主题和十个次主题。这些主题分别是:(1) 以自我为中心;(2) 超验的信仰体系;(3) 非宗教信仰体系;(4) 祈祷的重要性;(5) 作为固定和一致的 R/S 身份和实践;(6) 作为灵活、因地制宜和变革的 R/S 身份和实践。研究结果广泛地反映了有关 R/S 归属感的国家数据,包括无神论者、不可知论者或有灵性但无宗教信仰的人口比例不断增长的趋势;由于仇视变性人而与 R/S 社区产生的矛盾关系;以及 R/S 信仰和实践的支持性。讨论了对牧师实践的影响,包括牧师需要了解人口趋势以及 R/S 和变性恐惧症的交叉点。
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引用次数: 0
Providing spiritual care to cancer patients in the outpatient context: a pilot study. 在门诊环境中为癌症患者提供精神护理:一项试点研究。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-07-01 Epub Date: 2023-10-09 DOI: 10.1080/08854726.2023.2266303
Beth L Muehlhausen, Christa Chappelle, Allison DeLaney, David Peacock, R Greg Stratton, George Fitchett

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.

这项试点研究的目的是测试在阿森松岛医疗系统中为肿瘤门诊患者提供精神护理(SC)的努力。医疗服务提供者将受益于精神和情感支持的患者转诊。来自5个州的20名癌症门诊患者参与了该项目。根据牧师的评估,45%的患者有中度或重度精神问题。平均而言,患者与牧师进行了4次会谈(范围2-9)。在136次牧师会议中,56%是亲自到诊所,35%是通过电话。最常见的牧师活动是积极倾听(87%的课程)和表现出关心和关心(55%)。在提供随访数据的20名患者中,宗教/精神痛苦的所有指标都有所下降,尽管在统计学上不显著,但幸福感略有显著增加(p<.054)。这项研究补充了新出现的文献,这些文献描述了SC在门诊环境中的重要性。
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引用次数: 0
Navigating challenges in telechaplaincy: A thematic analysis of an international conference. 驾驭远程超灵的挑战:对一次国际会议的专题分析。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-07-01 Epub Date: 2023-12-19 DOI: 10.1080/08854726.2023.2294680
Fabian Winiger, Petra Sprik

Telehealth-based care models are being widely adopted by primary care providers and large healthcare institutions. Drawing on data collected at an international conference on the theory and practice of telechaplaincy, this article identifies and discusses how chaplains navigate various telechaplaincy-related challenges. A thematic analysis identified 49 codes and 11 themes at the individual-, organizational- and population levels. Presenters reported facing novel and qualitatively distinct challenges spanning an array of telechaplains' professional activities, including the structure of work routines, the types of interventions used, the ways provider-patient connections are established and experienced, the strategic positioning of chaplains, their role in the model of care, and ultimately, the populations served. It is argued that, though telechaplaincy has gained prominence since the Covid-19 pandemic, the maintenance of professional standards in digital care settings is a systemic challenge related to long-term trends towards outpatient care.

基于远程医疗的护理模式正被初级医疗服务提供者和大型医疗机构广泛采用。本文利用在一次关于远程牧师理论与实践的国际会议上收集到的数据,确定并讨论了牧师如何应对各种与远程牧师相关的挑战。主题分析从个人、组织和群体层面确定了 49 个代码和 11 个主题。演讲者报告了他们在一系列远程治疗师职业活动中面临的新颖且不同质量的挑战,包括工作例程的结构、所使用干预措施的类型、建立和体验提供者与患者之间联系的方式、牧师的战略定位、他们在护理模式中的角色,以及最终服务的人群。本文认为,尽管远程牧师在科维德-19 大流行病之后日益突出,但在数字护理环境中保持专业标准是一项系统性挑战,与门诊护理的长期趋势有关。
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引用次数: 0
Work-related perceptions and coping strategies of acute care chaplains: a qualitative analysis. 急性护理牧师的工作相关认知和应对策略:定性分析。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-07-01 Epub Date: 2023-10-19 DOI: 10.1080/08854726.2023.2270395
Stephanie L Harris, Amanda K Bailey

Hospital-based chaplains provide crucial spiritual and emotional care to patients, families, and staff during times of intense life changes and crises. Chaplains are regularly exposed to suffering and their work may result in personal mental and emotional health challenges. To understand chaplains' perceptions of the impact of their work and methods to cope, a secondary analysis of a mixed-methods study on chaplain well-being was undertaken. Qualitative interviews were conducted with nine hospital-based chaplains and data were coded and analyzed using thematic analysis. Results revealed that participants perceive their work as offering both trials and rewards, and their efforts to cope with trials include interpersonal support, intrapersonal resources, and spiritual resilience. Personal insights into chaplains' experiences may help inform organizational interventions to support these essential members of the care team.

在生活发生剧烈变化和危机时,医院牧师为患者、家人和工作人员提供至关重要的精神和情感护理。牧师经常遭受痛苦,他们的工作可能会给个人心理和情感健康带来挑战。为了了解牧师对其工作影响的看法和应对方法,对牧师幸福感的混合方法研究进行了二次分析。对9名医院牧师进行了定性访谈,并使用主题分析对数据进行了编码和分析。结果显示,参与者认为他们的工作既提供了考验,也提供了回报,他们应对考验的努力包括人际支持、个人资源和精神韧性。对牧师经历的个人见解可能有助于为组织干预提供信息,以支持护理团队的这些重要成员。
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引用次数: 0
Mapping spiritual care in small and critical access hospitals in a faith-based US Health system. 绘制以信仰为基础的美国医疗系统中小型医院和重症医院的灵性关怀图。
IF 1.1 Q1 Arts and Humanities Pub Date : 2024-06-21 DOI: 10.1080/08854726.2024.2354006
Kristen Schenk, Tyler Whipkey, George Fitchett

Little is known about spiritual care in small hospitals and critical access hospitals (CAHs), essential sources of health care in rural areas of the US. Using interview-administered surveys with spiritual care providers, we examined spiritual care services in 19 facilities, including seven small hospitals, nine CAHs, and three freestanding emergency departments, in one religiously-owned healthcare system. We identified four groups of facilities based on intensity/frequency of chaplain availability. A central finding was the variation in spiritual care services provided in these diverse facilities. Of the 16 hospitals in the sample, 11 of them (69%) offered spiritual care from professional chaplains at least three days per week. Support for staff was an important priority in all the facilities. Needs identified include virtual training and support for the spiritual care providers in these settings. Future research should replicate this study in a representative sample of hospitals that serve the rural US population.

小型医院和关键通道医院(CAHs)是美国农村地区重要的医疗机构,但人们对它们的灵性关怀却知之甚少。通过对灵性关怀提供者进行访谈调查,我们考察了一个宗教所有的医疗保健系统中 19 家机构的灵性关怀服务,其中包括 7 家小型医院、9 家 CAH 和 3 家独立急诊科。我们根据提供牧师服务的强度/频率确定了四组机构。一个核心发现是这些不同机构所提供的灵性关怀服务存在差异。在抽样调查的 16 家医院中,有 11 家(69%)每周至少有三天由专业牧师提供灵性关怀服务。为员工提供支持是所有机构的重要优先事项。已确定的需求包括为这些机构的灵性关怀提供者提供虚拟培训和支持。未来的研究应在服务于美国农村人口的具有代表性的医院样本中复制这项研究。
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引用次数: 0
期刊
Journal of Health Care Chaplaincy
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