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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 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub 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
Chaplaincy and outpatient cancer care in a faith-based health system: lessons learned when imbedding two full time chaplain positions in a cancer institute with a faith-based heritage. 以信仰为基础的医疗系统中的牧师和癌症门诊护理:在一家具有信仰传统的癌症研究所中设置两个全职牧师职位的经验教训。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-27 DOI: 10.1080/08854726.2024.2354000
Thomas Payne

There is interest in chaplains devoted to outpatient cancer care, informed by a growing body of research as well as recommendations of accreditors. Simultaneously, a growing share of U.S. healthcare is faith-based and possesses a foundational interest in religious/spiritual (R/S) care due to institutional culture. In that milieu, few articles describe how religious organizational cultures influence the creation and implementation of FTEs intended to meet the evidence-based recommendations of accreditors. This is a lacuna, given that board certified chaplains are measured on their ability to integrate spiritual care into the life and service of their institutions. In response, this article describes the creation and implementation of two chaplain positions devoted to a group of outpatient cancer clinics in a large Catholic healthcare system. This includes lessons learned when navigating R/S aspects of organizational cultures while implementing and executing chaplain practice to meet accreditor recommendations.

越来越多的研究以及认证机构的建议表明,人们对专门从事癌症门诊护理的牧师很感兴趣。与此同时,越来越多的美国医疗机构以信仰为基础,并因机构文化而对宗教/精神(R/S)护理产生了浓厚的兴趣。在这种环境下,很少有文章描述宗教组织文化如何影响创建和实施旨在满足评审员循证建议的全职培训。鉴于委员会认证的牧师是根据其将精神关怀融入机构生活和服务的能力来衡量的,因此这是一个空白。为此,本文介绍了在一个大型天主教医疗保健系统中专门为一组癌症门诊设立和实施两个牧师职位的情况。其中包括在实施和执行牧师实践以满足评审员建议的同时,在驾驭组织文化的 R/S 方面所汲取的经验教训。
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引用次数: 0
Pediatric chaplains iterative process to address religious & spiritual struggle: a qualitative study. 儿科牧师解决宗教和精神斗争的迭代过程:一项定性研究。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-03 DOI: 10.1080/08854726.2024.2354004
Salvador Leavitt-Alcántara, Angela R Meeks, Logan J Miller, Barbara K Giambra

The growing body of literature on religious and spiritual (R/S) struggles consistently highlights its association with various health outcomes in Pediatrics. Chaplains or spiritual care providers, as members of interdisciplinary teams, frequently offer spiritual care to patients and families grappling with R/S struggles. However, there is a paucity of literature demonstrating how chaplains address R/S struggle in their practice. This study aimed to construct a theory describing the process by which pediatric chaplains conceptualize and address it. Employing a constructivist Grounded Theory study design, we sought to comprehend the approaches pediatric chaplains utilize in addressing R/S struggles. Following a semi-structured interview guide, we interviewed twelve Board Certified or Board Certification-eligible chaplains. Findings reveal that chaplains use an iterative three-phase process to address R/S struggles. Thirteen categories emerged, which were further organized into four major themes: Assessing, Processing, Intervening, and Navigating Limitations. A model depicting this iterative process was constructed.

有关宗教和精神斗争(R/S)的文献越来越多,这些文献一致强调了宗教和精神斗争与儿科各种健康结果之间的关联。作为跨学科团队的成员,灵性导师或灵性关怀提供者经常为面临宗教与灵性斗争的患者和家属提供灵性关怀。然而,关于灵性导师如何在实践中解决 R/S 斗争问题的文献却很少。本研究旨在构建一种理论,描述儿科灵性辅导员将 R/S 斗争概念化并加以解决的过程。我们采用建构主义基础理论研究设计,试图了解儿科灵性辅导员在处理 R/S 斗争时所采用的方法。按照半结构化访谈指南,我们对 12 名获得委员会认证或有资格获得委员会认证的牧师进行了访谈。访谈结果显示,儿科灵性辅导员采用了三阶段的迭代过程来解决R/S问题。结果发现了 13 个类别,并进一步归纳为四大主题:评估、处理、干预和驾驭限制。我们构建了一个模型来描述这一迭代过程。
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引用次数: 0
Spiritual assessment models for palliative care chaplains: a narrative review. 姑息关怀牧师的精神评估模式:叙述性综述。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-20 DOI: 10.1080/08854726.2024.2368999
Paul K Galchutt

Palliative care chaplains conduct spiritual assessments for those within their care. This narrative review examined the literature concerning existing spiritual assessment models developed or designated for palliative care chaplain use. The literature review was performed using four databases, including a hand search of references due to the variability of keywords used within the spiritual care literature. Five spiritual assessment models were identified. The analysis of the models focused on three areas: (1) Foundational basis, (2) Spiritual needs, and (3) Structural frameworks. Published spiritual assessment models for palliative care chaplain use are variable in how each one was formed, how each tool describes and structures spiritual care needs, and how the models are implemented within their respective contexts. The PC-7 advances the field, especially through its mixed methods approach. Future validation and reliability research is needed as well as investigations concerning which models are taught by chaplain educators and used by palliative care chaplains.

姑息关怀灵性照护师为其照护对象进行灵性评估。本叙述性综述研究了有关现有灵性评估模型的文献,这些模型是为姑息关怀灵性照护牧师开发或指定使用的。文献综述使用了四个数据库,其中包括对参考文献的人工搜索,因为灵性关怀文献中使用的关键词各不相同。最后确定了五个灵性评估模型。对这些模式的分析主要集中在三个方面:(1)基础;(2)灵性需求;(3)结构框架。已出版的供姑息关怀牧师使用的灵性评估模型在以下方面各不相同:每个模型是如何形成的;每个工具是如何描述和构建灵性关怀需求的;以及这些模型是如何在各自的环境中实施的。PC-7 是这一领域的进步,尤其是通过其混合方法。未来还需要进行验证和可靠性研究,并调查牧师教育者教授和姑息关怀牧师使用的模式。
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引用次数: 0
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
Development of the ONC-5: A quantifiable assessment of spiritual concerns for adult oncology patients.
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-09-17 DOI: 10.1080/08854726.2024.2399992
Dirk Labuschagne, Patricia Palmer, Allison DeLaney, Kristen Schenk, George Fitchett

Religious and spiritual (R/S) beliefs are crucial coping resources for cancer patients, yet there's no standard spiritual assessment approach. We developed the ONC-5, an evidence-based model to quantify patients' spiritual concerns in adult oncology. Seventy-one patients with diverse cancer diagnoses completed a survey and a semi-structured ONC-5 interview with a chaplain. Measures included the distress thermometer, PHQ-2, R/S struggle, and spiritual well-being. Thirty interviews were reviewed for inter-rater reliability. Spearman correlations assessed validity, and the concordance correlation coefficient (CCC) was calculated for inter-rater reliability. Results showed 20% of patients had moderate or severe spiritual concerns. ONC-5 scores correlated with R/S struggle (r = .247; p = .038) and spiritual well-being (r = -.247; p = .038). The CCC of 0.4411 indicated moderate agreement. The ONC-5 helps chaplains identify spiritual concerns, prioritize care, and measure improvements. More research is needed to test its validity and reliability in diverse populations.

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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
"Genuine and fundamentally human": a qualitative study into Dutch humanist chaplains' conceptualizations of empathy. "真正的、基本的人类":对荷兰人文主义牧师的同理心概念的定性研究。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-04-01 Epub Date: 2023-01-27 DOI: 10.1080/08854726.2023.2169535
Jolanda van Dijke, Joachim Duyndam, Inge van Nistelrooij, Pien Bos

Empathy has been highlighted as a key concept in chaplaincy care, but its meaning has hardly been explored in depth within this field. This study aims to help develop stronger conceptual clarity by investigating humanist chaplains' conceptualizations of empathy. Data were collected through semi-structured interviews with twenty humanist chaplains working in health care, military, and prisons. A qualitative design was employed to clarify which components and features constitute empathy in humanist chaplaincy care. Empathy emerges as a multidimensional concept that is "fundamentally human." Chaplains distinguish between true and pseudo empathy based on different features including authenticity and concern. This article provides a conceptual model that combines the different components and features of empathy in humanist chaplaincy care and the relationship between them in light of empathy's humanizing quality. It may be used for educational purposes and could function as a conceptual framework for future research efforts.

移情已被强调为牧师关怀中的一个关键概念,但在这一领域中几乎没有对其含义进行过深入探讨。本研究旨在通过调查人文主义牧师对移情的概念理解,帮助进一步明确概念。研究人员通过半结构式访谈收集了 20 位在医疗保健、军队和监狱工作的人文主义牧师的数据。我们采用了定性设计的方法来阐明人文主义牧师护理中的移情由哪些部分和特征构成。移情是一个多维概念,是 "人类的根本"。牧师们根据不同的特征(包括真实性和关心)来区分真正的移情和虚假的移情。本文提供了一个概念模型,该模型结合了人文主义牧师关怀中共情的不同组成部分和特征,并根据共情的人性化特质分析了它们之间的关系。该模型可用于教育目的,并可作为未来研究工作的概念框架。
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引用次数: 0
期刊
Journal of Health Care Chaplaincy
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