Journal of Health Care Chaplaincy最新文献

This study investigated the reported workings of a narrative and interfaith spiritual care intervention in palliative care at home called "In dialogue with your life story." It was developed to address clients' spiritual needs in the religious plural context of the Netherlands. Thus far, how the intervention impacted clients' spiritual well-being remained a black box. A thematic analysis of semi-structured interviews with and workbooks of clients (N = 75) and chaplains (N = 33) indicated seven intervention elements that promoted clients' spiritual well-being in four ways: (1) they offered new insights and a better overview, (2) provided a place to connect and share experiences, (3) helped to reach deeper layers of meaning, and (4) brought out feelings of calmness and gratitude. The findings shed light on the intervention's black box and encourage further exploration of associations between chaplaincy goals, processes, and outcomes.

Several studies have examined the goals and outcomes of chaplaincy within institutional settings. Our study contributes to the literature by examining whether chaplaincy goals and outcomes are specific to different outpatient, primary, and community care contexts. We conducted a round of 9 and one of 8 focus groups, with clients, chaplains, and other professionals from five contexts: the Dutch earthquake zone, general healthcare, pediatric palliative care, care for the unhoused, and veteran care. Using an explorative, descriptive and quantitative design, 77 goals and 59 outcomes are compared and categorized in a four-quadrant framework. Our findings show few differences between goals and outcomes of different contexts. However, the goals of care for the unhoused and veterans focus more on the inner experience of the relationship with the chaplain. Non-context-specific goals and outcomes might be related to how chaplaincy is approached, and the context-specific ones to existential concerns in the care contexts.

Modern society is characterized by pluralism. We examine how chaplaincy encounters pluralism and what this might mean for chaplaincy and chaplaincy education. Religious pluralism impacts both how the profession is organized and how it is practiced. Financial and legislative structures play an important role in creating space for religious pluralism in chaplaincy. This intersects with "professional pluralism" within spiritual care. In many countries, spiritual care is increasingly considered a responsibility of a wide variety of healthcare professionals. This requires interprofessional collaboration in which different understandings of and approaches to spirituality and spiritual care need to be made explicit and negotiated. For chaplaincy and chaplaincy education, this has five important implications: a) developing interfaith competence as a Core Professional Skill; b) building a shared professional identity while honoring diversity; c) mastering interprofessional collaboration; d) addressing structural inequalities and power dynamics; and e) embracing both generic and specialized approaches to spiritual care.

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.

This article examines how hospital chaplains in Norwegian specialist healthcare support patients at risk of suicide, with particular attention to existential care within a pluralistic society. Based on qualitative data from four focus group interviews involving 16 chaplains across somatic and psychiatric units, the study explores how chaplains understand, experience, and reflect on their role in existential conversations. Three main themes emerged: the chaplains' theological and worldview profiles, their openness to diverse worldviews, and the dilemmas they face in balancing professional identity with interdisciplinary expectations. The findings highlight chaplains' capacity to create meaningful, non-judgmental spaces for dialogue, where suffering and hope can be explored. However, the absence of explicitly articulated frameworks may limit their visibility and integration in interdisciplinary care. The study underscores the importance of clarifying the chaplain's role in modern healthcare and developing shared professional language to strengthen existential care for patients in crisis.

Healthcare chaplains provide care within interprofessional collaborative contexts. However, little is known about their functional roles as collaborators and leaders, including what capabilities, influence, and skills chaplains leverage in their work. In Part 1 of a two-part scoping review, we examine chaplains' collaborative and leadership roles in interprofessional healthcare teams through mapping the existing research literature. We analyzed 53 empirical studies that met the inclusion criteria. Six collaborative roles for chaplains were identified: relationship and communication facilitation, consultation for whole-person care, education, staff support, research collaboration, and collaborative leadership. The latter category included five additional characteristic interprofessional leadership roles: leading by spiritual care expertise, fostering interprofessional collaboration, mediation and conflict management, advocacy and change leadership, and improving decision-making. In the service of whole-person care, we discuss research contributions and gaps, implications for practice, and recommendations for future research.

Interprofessional collaborative practice is integral to providing spiritual care and whole-person care. As interprofessional spiritual care models continue to evolve, existing research on chaplains' collaboration and leadership remains limited. In Part 2 of a two-part scoping review, we examine the factors that influence chaplains' collaboration and leadership. The review included 53 studies to map the relevant literature. Our analysis identified (a) four key factors: relational factors, the professional chaplain role, attitudes influencing collaboration, and leadership action, and (b) two contextual factors: power dynamics and organizational conditions that provide an embedded environment, dynamically shaping and interacting with facilitators and barriers. Findings provide valuable insights for the effective integration of chaplains in interprofessional practice and illuminate the need for proactive approaches from both chaplains and healthcare systems. Incorporating interprofessional education and shared experiences throughout chaplaincy training and professional development is essential to enhance chaplains' ability to collaborate and lead in interprofessional settings.

Smudging is a spiritual custom extensively practiced by American Indians, yet little is known about smudging in hospital settings. To better understand the spiritual needs of hospitalized American Indian patients, we performed a qualitative, exploratory, and cross-sectional study, consisting of semistructured interviews with nine hospitalized American Indian patients. We identified four major themes: accessibility, role of chaplains/staff, experiences of the ritual, and cultural connection. Smudging is an important component of holistic health care, contributing to patient well-being and satisfaction. .