Journal of Health Care Chaplaincy最新文献

Research to measure the value of chaplains is a burgeoning area of interest, as staffing decisions may be contingent on demonstrating a return on investment. Healthcare executives are often faced with difficult staffing decisions that require weighing the support of organizational mission with practical financial implications. This qualitative study utilized thematic analysis to present the perceptions of C-suite executives and two key constituencies - nurses and patients/family members - on the value of chaplains. Results indicate that all three groups value chaplains for their roles in providing support and comfort. Healthcare executives recognize the alignment of chaplains with organizational mission within a faith-based setting but also desire metrics that tie staffing to measurable outcomes. Other organizations exploring chaplain staffing and return on investment may benefit from using mixed-methods research to inform their decision-making.

Faith Group Endorsement (FGE) is required for the Association of Professional Chaplains (APC) board certification and the Association of Clinical Pastoral Education (ACPE) educator certification. It was established in the early days of professional chaplaincy but recent social changes, including changes in the U.S. religious landscape, create obstacles for obtaining and maintaining FGE for many candidates and raise questions about its value. We conducted focus groups and interviews with 78 key informants, examining the value of and the challenges associated with FGE. Participants reported that FGE is essential to the formation and identity of professional chaplains, but there are serious problems with the current process for obtaining FGE.

In 2022, the Spiritual Care (SC) program at Cedars-Sinai Health System in Southern California undertook an evaluation of their services. It included a survey and focus groups to learn how the staff at Cedars Sinai hospitals perceived and utilized SC services for patients, visitors, and themselves. Survey participants included 554 staff members; 314 of those reported direct contact with patients. The eight focus groups had 28 participants. Respondents with direct patient contact were aware that chaplains are available for patient and family support (302/314; 96%). A majority knew how to make a referral to SC (217/302; 72%). Focus group results emphasized the importance and value of SC while recommending ways to improve services. More education of staff is needed regarding what SC includes, when and how to refer patients to SC and the benefits of SC for staff.

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.

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.

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.

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.

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.

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.