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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
Becoming chaplains: How and why chaplains enter the field, factors involved and implications. 成为牧师:牧师如何及为何进入这一领域、相关因素及影响。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-04-01 Epub Date: 2022-12-14 DOI: 10.1080/08854726.2022.2154108
Robert Klitzman, Stephanie Sinnappan, Elizaveta Garbuzova, Jay Al-Hashimi, Gabrielle Di Sapia Natarelli

Many questions arise concerning how and why chaplains enter the field. Interviews of ∼1 one hour each were conducted with 23 U.S. chaplains. Chaplains vary widely in professional and personal backgrounds and experiences, which they often draw on in their work. Personal experiences can lead them to enter the field, enhance their empathy and strengthen their commitment. They have frequently faced significant trauma (e.g., parent's death) or helped family and/or friends with end-of-life challenges. Chaplains often entered other fields first (e.g., clergy, business or healthcare), but they often had incomplete or incorrect prior knowledge about the field. Prior experiences can also affect their work (e.g., in recognizing the power of silence). A sense of personal "calling" frequently leads chaplains to find their work deeply rewarding and sustaining. These data, the first to explore how and why chaplains enter the field, have critical implications for future practice, education and research.

关于牧师如何以及为何进入这一领域,出现了许多问题。我们对 23 名美国牧师进行了访谈,每次访谈时间为 1 小时。灵牧师的专业和个人背景及经历千差万别,他们在工作中经常会借鉴这些背景和经历。个人经历可以引导他们进入这一领域,增强他们的同理心,强化他们的承诺。他们经常面临重大创伤(如父母去世),或帮助家人和/或朋友应对临终挑战。灵性辅导员往往先进入其他领域(如神职人员、商业或医疗保健),但他们之前对该领域的了解往往不全面或不正确。先前的经历也会影响他们的工作(例如,认识到沉默的力量)。个人的 "呼召 "感常常会使牧师们发现他们的工作具有深远的意义和持续性。这些数据首次探讨了牧师如何以及为何进入这一领域,对未来的实践、教育和研究具有重要意义。
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引用次数: 0
"Reading" the room: healthcare chaplains' challenges, insights and variations in entering rooms and engaging with patients and families. "阅读 "病房:医疗牧师在进入病房与病人和家属接触时遇到的挑战、见解和变化。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-04-01 Epub Date: 2023-05-13 DOI: 10.1080/08854726.2023.2210029
Robert Klitzman, Gabrielle Di Sapia Natarelli, Stephanie Sinnappan, Elizaveta Garbuzova, Jay Al-Hashimi

Recent research has described broad types of healthcare chaplains' activities, but many questions remain about how these professionals perform these tasks, whether variations occur, and if so, in what ways. Twenty-three chaplains were interviewed in-depth. Chaplains described engaging in highly dynamic processes, involving both verbal and non-verbal interactions. They face challenges and vary in ways of starting interactions, using verbal and non-verbal cues, and communicating through physical appearance. In these processes, when entering patients' rooms, they seek to "read the room," follow patients' leads, look for cues, match the energy/mood in the room, and adjust their body language appropriately, while maintaining open-ended stances. They face choices of what, if anything, to communicate through clothing (e.g., wearing clerical collars or crosses) and can confront additional challenges with members of groups different than their own, at times requiring further sensitivity. These data, the first to examine challenges chaplains confront entering patients' rooms and engaging in non-verbal communication, can enhance understandings of these issues, and help chaplains and other healthcare professionals provide more sensitive and astute context-based care. These findings thus have critical implications for education, practice, and research concerning chaplains and other providers.

最近的研究描述了医护牧师活动的大致类型,但对于这些专业人员如何执行这些任务、是否存在差异以及如果存在差异,又是以何种方式执行的,仍然存在许多问题。我们对 23 名灵牧师进行了深入访谈。据灵牧师描述,他们从事的是高度动态的工作,涉及语言和非语言互动。他们在开始互动、使用言语和非言语暗示以及通过外表进行交流的方式上面临挑战并各不相同。在这些过程中,当进入病人房间时,他们会努力 "读懂房间",跟随病人的脚步,寻找线索,配合房间里的能量/情绪,适当调整自己的肢体语言,同时保持开放式的姿态。他们面临着通过服装(如佩戴教士领章或十字架)传达什么信息的选择(如果有的话),并可能在与不同群体成员相处时面临额外的挑战,有时需要进一步的敏感性。这些数据首次研究了牧师在进入病人房间和进行非语言交流时所面临的挑战,可以加深人们对这些问题的理解,帮助牧师和其他医护人员提供更加敏感和敏锐的基于情境的护理。因此,这些发现对有关牧师和其他医疗服务提供者的教育、实践和研究具有重要意义。
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引用次数: 0
Healthcare chaplains' conflicting and ambivalent positions regarding meaning in life and worldview. 医护牧师对人生意义和世界观的矛盾和冲突立场。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-04-01 Epub Date: 2023-05-10 DOI: 10.1080/08854726.2023.2210026
Gaby Jacobs, Carmen Schuhmann, Iris Wierstra

Western society is increasingly a spiritual society, but not so much a society that draws on clearly delineated religious or worldview pillars anymore. Within healthcare, there's a growing attention to the spiritual dimension of health and the collaborative spiritual care that is needed for person-centered care. This changing religious/worldview and healthcare landscape is influencing healthcare chaplaincy. In this case study in-depth interviews were conducted with a chaplaincy team within a large healthcare organization in The Netherlands. Dialogical Self Theory was used as the theoretical framework in the narrative analysis of these stories. This provided insights into how these chaplains negotiate their professional identity within a changing healthcare landscape. It is concluded that there are multiple and often contradictory and conflicting positions within and between chaplains and that it is a challenge for healthcare chaplains to integrate the "old" and "new" representations of chaplaincy.

西方社会日益成为一个精神社会,但不再是一个以明确的宗教或世界观为支柱的社会。在医疗保健领域,人们越来越关注健康的精神层面以及以人为本的医疗保健所需的合作性精神关怀。这种不断变化的宗教/世界观和医疗保健环境正在影响着医疗保健牧师的工作。本案例研究对荷兰一家大型医疗机构的牧师团队进行了深入访谈。在对这些故事进行叙事分析时,采用了对话自我理论作为理论框架。这为了解这些牧师如何在不断变化的医疗保健环境中协商他们的职业身份提供了见解。结论是,在牧师内部和牧师之间存在着多重立场,而且往往是相互矛盾和冲突的立场,对于医疗保健牧师来说,整合牧师的 "新""旧 "表述是一项挑战。
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引用次数: 0
How does the American public interact with chaplains? Evidence from a national survey. 美国公众如何与牧师互动?一项全国性调查提供的证据。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-04-01 Epub Date: 2023-07-24 DOI: 10.1080/08854726.2023.2239109
Amy Lawton, Wendy Cadge, Jessica Hamar Martinez

How does the American public understand the term chaplain? What fraction interact with chaplains and in what settings? What is the content of those interactions and do care recipients find them valuable? We answer these questions with data from a nationally representative survey (N = 1096) conducted in March 2022 and interviews with a subset (N = 50) of survey recipients who interacted with chaplains. We find that people in the United States do not have a consistent understanding of the term chaplain. Based on our definition, at least 18% of Americans have interacted with a chaplain. Among those who interacted with a chaplain as defined in the survey, the majority did so through healthcare organizations. Care recipients include people who were ill and their visitors/caregivers. The most common types of support received were prayer, listening and comfort. Overall, survey respondents found chaplains to be moderately or very valuable.

美国公众如何理解牧师一词?哪些人群在哪些场合与牧师互动?这些互动的内容是什么,接受护理者是否认为这些互动很有价值?我们通过 2022 年 3 月进行的一项具有全国代表性的调查(N = 1096)中的数据,以及对一部分(N = 50)曾与牧师互动的调查对象进行的访谈,回答了这些问题。我们发现,美国人对牧师一词的理解并不一致。根据我们的定义,至少有 18% 的美国人与牧师有过互动。在与调查中定义的牧师有过互动的人中,大多数人是通过医疗机构与牧师互动的。护理对象包括患病者及其探视者/护理者。最常见的支持类型是祈祷、倾听和安慰。总体而言,调查对象认为牧师的价值一般或非常高。
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引用次数: 0
Supporting staff: The role of health care chaplains. 支持工作人员:医护牧师的作用。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-01-01 Epub Date: 2022-12-15 DOI: 10.1080/08854726.2022.2154107
Alexander Tartaglia, Kelsey B White, Tyler Corson, Ann Charlescraft, Tricia Johnson, Elizabeth Jackson-Jordan, George Fitchett

The aim of this study was to describe the range of spiritual care activities in support of clinical colleagues at a subset of U.S. hospitals. A descriptive cross-sectional design using a 76-item Zoom/telephone guided survey containing a subset of staff care questions was employed. Data were provided by directors/managers responsible for spiritual care services at the 2020-2021 U.S. News & World Report top hospitals. Results identified staff support as an important chaplaincy function at both organizational and spiritual care department levels. Staff chaplains at over half of the hospitals spend an estimated 10-30% of their time on staff care, with chaplains in five hospitals spending greater than 30%. The most frequently reported activities were religiously associated, such as blessings and rituals for hospital events. Additionally, chaplains actively support staff during critical events such as patient deaths and through organizational protocols such as code lavender and critical incident debriefings. Chaplain support for staff most commonly grew out of personal relationships or referrals from clinical managers. Future research opportunities in this area include systematic data collection for chaplains' specific staff support activities as well as efforts to investigate the impact of those activities on patient experience.

本研究旨在描述美国部分医院为支持临床同事而开展的精神关怀活动的范围。研究采用了描述性横断面设计,使用了包含 76 个项目的 Zoom/电话指导调查,其中包含一组员工关怀问题。数据由 2020-2021 年《美国新闻与世界报道》顶级医院负责灵性关怀服务的院长/经理提供。调查结果显示,无论是在组织层面还是在灵性关怀部门层面,员工支持都是一项重要的牧师职能。半数以上医院的灵性牧师将大约 10%-30% 的时间用于员工关怀,其中有五家医院的灵性牧师将超过 30% 的时间用于员工关怀。报告最多的活动与宗教有关,如为医院活动祈福和举行仪式。此外,在病人死亡等重大事件中,以及通过 "薰衣草代码 "和 "重大事件汇报 "等组织协议,院牧会积极为员工提供支持。牧师对员工的支持通常来自于个人关系或临床管理人员的转介。该领域未来的研究机会包括系统地收集有关牧师为员工提供具体支持活动的数据,以及调查这些活动对患者体验的影响。
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引用次数: 0
Increasing chaplain support for veterans at high risk for suicide through targeted outreach: A quality improvement initiative. 通过有针对性的外展活动,增加牧师对高自杀风险退伍军人的支持:一项质量改进举措。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-01-01 Epub Date: 2022-10-26 DOI: 10.1080/08854726.2022.2136466
Melissa A Smigelsky, Justin L Maynard, C Graham Ford, Ryan Parker, Jennifer H Wortmann, Keith G Meador, Anna Fink, Jason A Nieuwsma

The Department of Veterans Affairs (VA) has prioritized improving the identification of veterans at risk for suicide and ensuring adequate staffing of personnel to assist veterans in need. It is imperative that suicide prevention efforts make use of the full range of available resources, including diverse professionals with distinctive skillsets. Chaplains are engaged in suicide prevention efforts in VA, but the literature lacks examples of chaplain-involved suicide prevention efforts that clearly describe how chaplains are engaged, the training and/or qualifications chaplains possess in the area of suicide prevention, and the reach and impact of such efforts. The purpose of this report is to describe the development and implementation of a novel, innovative, and ongoing chaplain-led suicide prevention outreach initiative for veterans at high risk for suicide. Results indicated the program was feasible and supported at the systems level, and chaplains were able to collaboratively sustain outreach efforts over the course of a year. Chaplain suicide prevention outreach was found to be acceptable to veterans, who overwhelmingly indicated openness to and appreciation for outreach. Chaplains can address the spiritual crisis underlying suicidality, bolster spiritual protective factors, and are a part of holistic care. Considerations for implementation and future investigation are discussed.

退伍军人事务部(VA)已经优先考虑提高对有自杀风险的退伍军人的识别,并确保有足够的人员来帮助有需要的退伍军人。预防自杀的努力必须充分利用各种可用资源,包括具有独特技能的各种专业人员。在退伍军人事务部,牧师从事自杀预防工作,但文献中缺乏牧师参与自杀预防工作的例子,这些例子不能清楚地描述牧师是如何参与的,牧师在自杀预防领域的培训和/或资格,以及这种努力的范围和影响。本报告的目的是描述一种新颖的、创新的、持续的牧师领导的自杀预防推广倡议的发展和实施,该倡议针对自杀风险高的退伍军人。结果表明,该计划是可行的,并得到了系统层面的支持,牧师们能够在一年的时间里共同维持外展工作。退伍军人可以接受牧师的自杀预防外展,他们绝大多数表示对外展持开放态度和赞赏态度。牧师可以解决自杀背后的精神危机,加强精神保护因素,是整体护理的一部分。讨论了实施的注意事项和未来的研究。
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引用次数: 0
When and why patients and families reject chaplains: challenges, strategies and solutions. 病人和家属拒绝牧师的时间和原因:挑战、策略和解决方案。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2024-01-01 Epub Date: 2022-11-26 DOI: 10.1080/08854726.2022.2150026
Robert Klitzman, Gabrielle Di Sapia Natarelli, Elizaveta Garbuzova, Stephanie Sinnappan, Jay Al-Hashimi

Hospital chaplains perform important activities, but critical questions arise about the challenges they may face in working with patients, and how these professionals respond. Thirty-three telephone interviews of approximately 1 hour and were conducted with 21 board-certified chaplains. When asked about their biggest challenges and most rewarding interactions, several chaplains described rejections by patients or families. Patients and families at times rejected chaplains, and did so for six broad types of reasons - not wanting to discuss the disease due to conflicted feelings, including anger or frustration at the patient, the cosmos or God; or wanting to minimize it; wanting a chaplain of their own faith; or of a particular gender or other characteristic; being atheist or wary of religion; or misunderstanding what chaplains do. Patients at times also disagreed with family members about whether to reject a chaplain. Chaplains responded variously: feeling transitory hurt (which generally decreases with experience); respecting patients' autonomy and leaving; exploring reasons for rejection; and revisiting later and often then making helpful connections. These data have important implications for future practice, education and research regarding chaplains and other providers - suggesting, for example, how patients' families and the public might benefit from increased understanding about the field.

医院牧师从事着重要的工作,但他们在与病人合作时可能会面临哪些挑战,这些专业人士又是如何应对的,这些都是至关重要的问题。我们对 21 位经委员会认证的牧师进行了 33 次电话访谈,每次约 1 小时。当被问及最大的挑战和最有意义的互动时,几位牧师描述了病人或家属对他们的排斥。患者和家属有时会拒绝牧师,拒绝的原因大致有六种--由于矛盾的情绪(包括对患者、宇宙或上帝的愤怒或沮丧)而不想讨论疾病;或希望将疾病最小化;希望牧师具有自己的信仰;或具有特定的性别或其他特征;是无神论者或对宗教有戒心;或误解牧师的工作。在是否拒绝牧师的问题上,患者有时也会与家属意见不一。灵性辅导员做出了不同的回应:感到短暂的伤害(这种伤害通常会随着经验的积累而减少);尊重患者的自主权并离开;探究拒绝的原因;稍后再次拜访并经常建立有益的联系。这些数据对未来有关灵牧师和其他服务提供者的实践、教育和研究具有重要意义--例如,建议病人家属和公众如何从增加对这一领域的了解中获益。
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引用次数: 3
Interprofessional communication training to address spiritual aspects of cancer care. 跨专业沟通培训,以解决癌症护理的精神方面。
IF 1.1 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-10-01 Epub Date: 2022-07-19 DOI: 10.1080/08854726.2022.2097781
Betty R Ferrell, Haley Buller, Judith A Paice, Myra Glajchen, Trace Haythorn

Effective communication is essential for palliative care clinicians to provide quality spiritual care to cancer patients. Despite attention to spiritual needs having the potential to positively impact a patient's quality of life, clinicians continue to report a lack of confidence in addressing a patient's spiritual distress. This article addresses the development of a 3-day train-the-trainer communication cancer education program (ICC: Interprofessional Communication Curriculum) organized by the 8 domains of the National Consensus Project for Quality Palliative Care. The main objectives of ICC are to train adult oncology clinicians (nurses, social workers, and chaplains) in communication skills across all aspects of palliative care and to help prepare them to provide communication skills training to their colleagues at their home institutions. ICC participants attend in dyads consisting of differing disciplines and create 3 goals for implementing institutional change. To date, 126 participants (69 teams) have attended an ICC training. Pre-course survey results identified spiritual care as participants' least effective area of communication. Immediate post-course evaluation data revealed the spiritual care module and its subsequent lab session as the most useful sessions to participant's practice. Data from the 6-and-12-months post-course follow-up revealed participant's quality improvement projects focused heavily on improving spiritual care.

有效的沟通对于姑息治疗临床医生为癌症患者提供高质量的精神护理至关重要。尽管对精神需求的关注有可能对患者的生活质量产生积极影响,但临床医生仍报告称,他们对解决患者的精神痛苦缺乏信心。本文介绍了由全国优质姑息治疗共识项目的8个领域组织的为期3天的癌症沟通培训教育计划(ICC:跨专业沟通课程)的发展。ICC的主要目标是培训成年肿瘤学临床医生(护士、社会工作者和牧师)在姑息治疗的各个方面的沟通技能,并帮助他们为在家机构为同事提供沟通技能培训做好准备。国际商会的参与者分为两组,由不同的学科组成,并为实施机构变革制定了3个目标。迄今为止,已有126名参与者(69个小组)参加了国际商会的培训。课程前的调查结果表明,精神关怀是参与者最不有效的沟通领域。课程后即时评估数据显示,精神关怀模块及其随后的实验室会议是参与者实践中最有用的会议。来自6个月和12个月的课程后随访的数据显示,参与者的质量改进项目主要集中在改善精神护理上。
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引用次数: 0
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Journal of Health Care Chaplaincy
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