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Hospital chaplains facing the pandemic. A qualitative study. 面对疫情的医院牧师。定性研究。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-01-01 DOI: 10.1080/08854726.2022.2043680
Jan Domaradzki

The article explores hospital chaplains perspective on the impact of the coronavirus pandemic on the provision of spiritual care in Poland. Semi-structured interviews with sixteen hospital chaplains providing spiritual care in hospitals during the COVID-19 pandemic were performed. Six main themes emerged during the interviews: chaplains' experience of the pandemic, chaplaincy during the outbreak, patients' needs, health professionals needs, social stigma and discriminatory behaviours against chaplains, and the importance of spiritual care during the crisis. Results indicate that although the COVID-19 crisis has limited the possibilities of providing spiritual care in hospitals and has changed its nature, it has positively impacted the visibility of hospital chaplaincy. It also underpins the contribution of hospital chaplains to modern healthcare practice and suggests that chaplains role as key healthcare workers should be further recognized and their integration into the healthcare system is required.

本文探讨了医院牧师对冠状病毒大流行对波兰提供精神护理的影响的看法。对16名在COVID-19大流行期间在医院提供精神护理的医院牧师进行了半结构化访谈。访谈期间出现了六个主要主题:牧师在大流行病中的经历、爆发期间的牧师工作、病人的需要、保健专业人员的需要、对牧师的社会耻辱和歧视行为,以及危机期间精神关怀的重要性。结果表明,尽管新冠肺炎危机限制了医院提供精神关怀的可能性,并改变了其性质,但它对医院牧师的知名度产生了积极影响。它还支持了医院牧师对现代医疗实践的贡献,并建议牧师作为关键医疗工作者的角色应该进一步得到认可,并且需要他们融入医疗保健系统。
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引用次数: 1
A thematic analysis of a survey of hospital chaplains on death by neurologic criteria. 以神经病学标准对医院牧师死亡调查的专题分析。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-01-01 DOI: 10.1080/08854726.2022.2040893
Elizabeth Kitamura, Ariane Lewis

Introduction: Little is known about chaplains' views on brain death/death by neurologic criteria (BD/DNC). Thematic analysis of comments made by hospital chaplains about BD/DNC can illuminate their perspectives on working with patients, families, and interdisciplinary teams during assessment for BD/DNC.

Materials and methods: In an electronic survey distributed to members of five chaplaincy organizations between February and July 2019, we elicited free-text comments about BD/DNC. We performed a thematic analysis of the comments.

Results: Four themes were present: (1) definition of life and death, (2) respect with a subtheme of physician obligation, (3) collaboration with a subtheme of communication, and (4) education with a subtheme of scepticism.

Conclusions: Hospital chaplains are essential members of the interdisciplinary team involved in BD/DNC evaluation. They aim to ensure the interaction between families and the interdisciplinary team at the boundary of life and death and the intersection between religion and medicine is respectful, collaborative, and educational.

导言:关于牧师对脑死亡/按神经学标准死亡(BD/DNC)的看法,我们知之甚少。对医院牧师关于BD/DNC的评论进行专题分析,可以阐明他们在BD/DNC评估过程中与患者、家属和跨学科团队合作的观点。材料和方法:在2019年2月至7月期间,我们向五个牧师组织的成员分发了一项电子调查,以获取有关BD/DNC的自由文本评论。我们对评论进行了专题分析。结果:存在四个主题:(1)生与死的定义,(2)尊重与医生义务的子主题,(3)合作与沟通的子主题,(4)教育与怀疑的子主题。结论:医院牧师是参与BD/DNC评估的跨学科团队的重要成员。他们的目标是确保家庭和跨学科团队之间在生与死的边界以及宗教和医学之间的交叉点之间的互动是尊重,协作和教育的。
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引用次数: 0
Addressing spiritual needs in palliative care: proposal for a narrative and interfaith spiritual care intervention for chaplaincy. 解决精神需求在姑息治疗:建议一个叙事和跨信仰的精神护理干预牧师。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-01-01 DOI: 10.1080/08854726.2021.2015055
Iris R Wierstra, Anke I Liefbroer, Lenneke Post, Thijs Tromp, Jacques Körver

Although many recognize the importance of addressing the spiritual domain in palliative care, empirically grounded interventions designed to alleviate spiritual needs for patients in palliative care are remarkably scarce. In this paper we argue that the development of such interventions for chaplains is important in order to improve spiritual care in a (post)secular and religiously plural context. We therefore propose an interfaith chaplain-led spiritual care intervention for home-based palliative care that addresses patients' spiritual needs. The intervention is based on elements of spiritual care interventions that have been investigated among other populations. Three important characteristics of the proposed intervention are (1) life review; (2) materiality, ritual and embodiment; and (3) imagination. The aim of this intervention is to improve palliative patients' spiritual wellbeing. It is anticipated that such a structured intervention could assist in improving spiritual care in palliative care.

尽管许多人认识到在姑息治疗中解决精神领域的重要性,但旨在减轻姑息治疗患者精神需求的经验基础干预措施非常稀少。在本文中,我们认为,为了在(后)世俗和宗教多元的背景下改善精神护理,牧师的这种干预措施的发展是重要的。因此,我们提出了一个跨信仰的牧师领导的精神护理干预,以家庭为基础的姑息治疗,解决病人的精神需求。这种干预是基于在其他人群中调查过的精神护理干预的要素。建议干预的三个重要特征是:(1)生命回顾;(2)物质性、仪式性、体现性;(3)想象力。这种干预的目的是改善姑息治疗患者的精神健康。预计这种有组织的干预可以帮助改善姑息治疗中的精神护理。
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引用次数: 2
CPE for leaders: Adapting Clinical Pastoral Education's learning methodology for healthcare managers and directors. 领导CPE:适应临床教牧教育的学习方法为医疗保健经理和主任。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2022-10-01 Epub Date: 2021-06-07 DOI: 10.1080/08854726.2021.1929765
Jo Hirschmann, David W Fleenor, Rachel Van Thyn, Vansh Sharma

Clinical Pastoral Education (CPE), a training program for spiritual care providers, was adapted to meet the leadership development needs of a group of six healthcare managers. A focus group was conducted with the six participants to learn more about the program and its effects. Using thematic analysis, transcripts of the focus group were analyzed and seven themes were identified. Participants reported that the program facilitated trust and honesty, helped them connect to their emotions, and helped them respond to system-wide changes at work; that learning was facilitated by their connections with their peers in the group and with the facilitator; and that senior leaders' support for the program was key. They also reported that the name and course description were initially unclear and they wanted a follow-up program. This paper describes the program, presents these themes, and places CPE for Leaders in the context of other leadership models.

临床教牧教育(CPE)是一项针对精神护理提供者的培训计划,旨在满足六名医疗保健管理人员的领导力发展需求。六名参与者参加了一个焦点小组,以了解更多关于该计划及其效果的信息。通过专题分析,对焦点小组的记录进行了分析,确定了七个主题。参与者报告说,该项目促进了信任和诚实,帮助他们与自己的情绪联系起来,并帮助他们应对工作中全系统的变化;这种学习是通过他们与小组中的同伴和引导者的联系来促进的;高层领导对这个项目的支持是关键。他们还报告说,最初的名称和课程描述不清楚,他们想要一个后续项目。本文描述了该计划,提出了这些主题,并将CPE的领导者在其他领导模式的背景下。
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引用次数: 1
Board certification of professional chaplains: a qualitative study of stakeholder perspectives. 专业牧师的董事会认证:利益相关者视角的定性研究。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2022-10-01 Epub Date: 2021-06-01 DOI: 10.1080/08854726.2021.1916334
Kelsey B White, Ryan M Combs, Hallie R Decker
Abstract Many professional chaplaincy organizations in the United States have board certified healthcare chaplains since the 1920s and documented how they have adapted their process as the profession has grown. In 2019, the Association of Professional Chaplains and the National Association of Catholic Chaplains sought the perspectives of key stakeholders about professional chaplaincy board certification. This study reports the results from 50 semi-structured interviews with certification candidates, certification committee members, and chaplaincy managers in the United States. Participants discussed the preparation of the certification application, the certification interview, the ease and difficulty of certification competencies, and the evolving workforce. This study demonstrated divergent views on many aspects of board certification, but participants predominately respected and valued the process. Chaplains with varying levels of experience discussed how board certification strengthens multidisciplinary respect and collaboration. Participants reported difficulties with competencies that required translating between theory and practice.
自20世纪20年代以来,美国的许多专业牧师组织都有董事会认证的医疗保健牧师,并记录了他们如何随着职业的发展而适应自己的过程。2019年,专业牧师协会和全国天主教牧师协会就专业牧师委员会认证征求了主要利益相关者的观点。本研究报告了对美国50位认证候选人、认证委员会成员和牧师经理进行的半结构化访谈的结果。与会者讨论了认证申请的准备、认证面试、认证能力的难易程度以及不断发展的劳动力。这项研究显示了对董事会认证的许多方面的不同看法,但参与者主要是尊重和重视这个过程。具有不同经验水平的牧师讨论了委员会认证如何加强多学科的尊重和合作。参与者报告了需要在理论和实践之间进行转换的能力方面的困难。
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引用次数: 0
Inpatient pediatric chaplain service utilization among children with chronic, non-cancer diseases. 慢性非癌症儿童住院儿童牧师服务的利用。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2022-10-01 Epub Date: 2021-12-19 DOI: 10.1080/08854726.2021.2015054
Hannah Case, Tyler Benning, Zachary Lovig, Jeramy Girard, Megan Thorvilson, Philip R Fischer, Jason Homme

Despite the broad importance of pediatric spiritual care, most research focuses on oncologic and palliative care contexts. We aim to describe the utilization of pediatric chaplain services by children hospitalized for non-cancer chronic illnesses and to identify factors that predict utilization of chaplain services. Among 629 patients with 915 admissions, we found chaplain services were utilized in 5.0% of admissions. Utilization was similar between religiously affiliated patients (7.5%, 95%CI [5.3-10.6%]) and un-affiliated patients (6.4%, [3.6-11.0%]). Christian patients (7.3% [5.1-10.5%]) demonstrated similar utilization as non-Christian patients (7.0% [4.3-11.2%]). Utilization was significantly higher among patients with LOS >2 days (10.8% [7.9-14.6%]), compared to LOS ≤2 (1.7% [0.9-3.1%]). These results may represent an addressable gap in spiritual care, and they highlight an opportunity for pediatric chaplains to play a larger role in the holistic care of hospitalized children with chronic diseases, regardless of religious affiliation.

尽管儿科精神护理具有广泛的重要性,但大多数研究都集中在肿瘤和姑息治疗方面。我们的目的是描述非癌症慢性疾病住院儿童对儿童牧师服务的利用,并确定预测牧师服务利用的因素。在629名患者和915名入院者中,我们发现有5.0%的入院者使用了牧师服务。有宗教信仰的患者(7.5%,95%CI[5.3-10.6%])和无宗教信仰的患者(6.4%,[3.6-11.0%])的使用率相似。基督徒患者(7.3%[5.1-10.5%])与非基督徒患者(7.0%[4.3-11.2%])的使用率相似。LOS >2天的患者的使用率(10.8%[7.9-14.6%])明显高于LOS≤2天的患者(1.7%[0.9-3.1%])。这些结果可能代表了精神护理方面的一个可解决的差距,它们突出了儿科牧师在慢性疾病住院儿童的整体护理中发挥更大作用的机会,而不管宗教信仰如何。
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引用次数: 1
Professional development for spiritual care practitioners: a program review. 精神护理从业者的专业发展:项目回顾。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2022-10-01 Epub Date: 2021-06-07 DOI: 10.1080/08854726.2021.1916337
Heather Tan, Cheryl Holmes

Professional development is a crucial aspect for further successful progression of an individual's skills and effective function in their role. It is also a compulsory part of registration for most professionals in the health care sector. This article reports on the evaluation of a monthly professional development program, specifically for spiritual care practitioners, offered over the period 2017-2019 by Spiritual Health Association (Victoria, Australia) and its partners. Many common themes such as motivation, culture, purpose and areas for improvement have been identified and are further examined. Recommendations such as greater emphasis on the professionalism in the sector, broader inclusions of sessions across culture and ethnicity and the development of cross disciplinary communication skills are made for the future of this program.

专业发展是个人技能进一步成功发展和有效发挥其作用的关键方面。这也是医疗保健部门大多数专业人员注册的强制性部分。本文报告了精神健康协会(澳大利亚维多利亚州)及其合作伙伴在2017-2019年期间提供的专门针对精神护理从业者的月度专业发展计划的评估。许多共同的主题,如动机、文化、目的和需要改进的领域已被确定并进一步审查。对该计划的未来提出了一些建议,如更加强调该部门的专业性,更广泛地包括跨文化和种族的会议,以及发展跨学科的沟通技巧。
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引用次数: 0
An effective in-hospital chaplaincy-led care program for nurses: Tea for the soul a qualitative investigation. 一个有效的医院内牧师领导的护士护理项目:心灵之茶:一项定性调查。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2022-10-01 Epub Date: 2021-06-24 DOI: 10.1080/08854726.2021.1932134
Annette Callis, Marysol Cacciata, Mary Wickman, Joseph Choi

Tea for the Soul (TFS) is an understudied care model, addressing bereavement and other emotional needs of nurses related to impactful patient care experiences. Nurses are at high risk for compassion fatigue, moral distress, and burnout. Facilitated by a Chaplain, the TFS program provides participants a venue to express their feelings and explore ways of adapting effectively with the death of a patient, and other traumatic workplace experiences. In this qualitative grounded theory study, hospital nurses (N = 7) who participated in TFS were interviewed. IRB approval was obtained. Questions were constructed within the context of the medical center research council and asked if TFS: (a) was personally beneficial, (b) helped nurses feel better about their work, and (c) affected job satisfaction. Four core themes emerged: (a) Nurses' Self-Care, (b) Professional Practice, (c) Community, and (d) Improved Patient Care Outcomes. The Roy Adaptation Model, Group Identity Mode was applied to the content analysis. Overarching themes were Compassionate Service, Ministry of Presence, Reflective Practice, and Sacred Encounters. Nurses reported that TFS facilitated a spiritual respite and a sense of enhanced community and was a source of strength and coping, thus may aid in the promotion of nurse well-being and the amelioration of moral distress, compassion fatigue, and burnout.

心灵茶(TFS)是一种研究不足的护理模式,解决了与有影响力的病人护理经验相关的护士的丧亲和其他情感需求。护士有很高的同情疲劳、道德困境和倦怠的风险。在牧师的协助下,TFS项目为参与者提供了一个表达自己感受的场所,并探索有效适应病人死亡和其他创伤性工作经历的方法。在本定性扎根理论研究中,对参与TFS的医院护士(N = 7)进行访谈。获得IRB批准。问题是在医疗中心研究委员会的背景下构建的,并询问TFS是否:(a)对个人有益,(b)帮助护士对他们的工作感觉更好,(c)影响工作满意度。出现了四个核心主题:(a)护士的自我护理,(b)专业实践,(c)社区,(d)改善患者护理结果。运用Roy适应模型、群体认同模型进行内容分析。总体主题是慈悲服务,临在事工,反思实践和神圣相遇。护士报告说,TFS促进了精神上的喘息和增强的社区意识,是力量和应对的来源,因此可能有助于促进护士的福祉,改善道德困境,同情疲劳和倦怠。
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引用次数: 7
The CASH assessment tool: A window into existential suffering. 现金评估工具:了解存在的痛苦的窗口。
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2022-10-01 Epub Date: 2021-05-19 DOI: 10.1080/08854726.2021.1922980
Elizabeth Higgins, Hannah L Coyne, Catherine K Mahrer Rogers, James Infanzon, Nicholas Velez, Patrick Coyne

Spiritual beliefs and practices have long served as a critical component of treating or managing serious illness. There is evidence to suggest that patients would like healthcare professionals to address their existential and spiritual needs. The CASH Assessment Tool focuses on four key areas of spiritual concern: Care, Assistance/Help, Stress, and Hopes/Fears. In this QI Project, a palliative care team within an urban, safety net, tertiary-care, and academic healthcare setting sought to elicit themes from the CASH assessment used by chaplains caring for patients with serious illnesses. Thirty patients were included in the pilot. Themes identified included knowing the patient as a person, concern about loved ones, concern about pain, and fear of death. We found that the CASH Assessment Tool was able to demonstrate the existential concerns of patients and serve as a framework for discussion about concerns and hopes of patients with serious illness.

长期以来,精神信仰和实践一直是治疗或管理严重疾病的关键组成部分。有证据表明,患者希望医疗保健专业人员解决他们的存在和精神需求。CASH评估工具侧重于精神关怀的四个关键领域:关怀、援助/帮助、压力和希望/恐惧。在这个QI项目中,一个城市、安全网、三级医疗和学术医疗环境中的姑息治疗团队试图从照顾重病患者的牧师使用的CASH评估中得出主题。30名病人参加了试验。确定的主题包括了解病人是一个人,关心所爱的人,关心痛苦和对死亡的恐惧。我们发现CASH评估工具能够展示患者存在的关注,并作为讨论重症患者关注和希望的框架。
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引用次数: 0
Spiritual Resources of Family Members of Patients in Palliative Care in Brazil. 巴西姑息治疗患者家属的精神资源
IF 1.9 Q4 HEALTH POLICY & SERVICES Pub Date : 2022-10-01 Epub Date: 2021-10-28 DOI: 10.1080/08854726.2021.1993120
Hartmut August, Mary Rute G Esperandio

Although religiosity is a strong feature of Brazilian people, the integration of spirituality in palliative care (PC) has been a challenge for health care professionals. In order to evaluate the spiritual resources used by family members of patients in PC, this work presents the results of the research carried out with 50 family members. The Satisfaction with Life Scale, Centrality of Religiosity Scale, Spiritual/Religious Coping Scale, Religious and Spiritual Struggles Scale, and Attachment to God Inventory were applied. The prevalence of positive spiritual/religious coping was very high (76%) or high (6%). There was a strong correlation between positive spiritual/religious coping and centrality of religiosity (r = 0.805; SD = 0.87). There was a moderate negative correlation between the avoidant attachment to God and centrality of religiosity (r = -0.611; SD = 1.24) and positive spiritual/religious coping (r = -0.575; SD = 1.37). There was a moderate positive correlation between the anxious attachment to God and spiritual struggles (r = 0.515; SD = 0.76) and negative spiritual/religious coping (r = 0.555; SD = 0.616). These results suggest that spiritual/religious resources are present in family members of patients in PC. These resources have been mostly ignored by the multidisciplinary team. Findings provide an evidence base for training health care professionals to better integrate spirituality in PC settings.

虽然宗教信仰是巴西人民的一个强烈特征,但将灵性融入姑息治疗(PC)一直是卫生保健专业人员面临的挑战。为了评估PC患者家属对精神资源的使用情况,本研究报告了对50名家庭成员的调查结果。采用生活满意度量表、宗教中心性量表、精神/宗教应对量表、宗教与精神斗争量表和对上帝的依恋量表。积极的精神/宗教应对的患病率非常高(76%)或很高(6%)。积极的精神/宗教应对与宗教虔诚中心性有很强的相关性(r = 0.805;Sd = 0.87)。逃避型上帝依恋与宗教虔诚中心性存在中度负相关(r = -0.611;SD = 1.24)和积极的精神/宗教应对(r = -0.575;Sd = 1.37)。对神的焦虑依恋与属灵挣扎有中度正相关(r = 0.515;SD = 0.76)和消极的精神/宗教应对(r = 0.555;Sd = 0.616)。这些结果表明精神/宗教资源存在于PC患者的家庭成员中。这些资源大多被多学科团队所忽视。研究结果为培训卫生保健专业人员更好地将灵性融入个人电脑环境提供了证据基础。
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引用次数: 2
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Journal of Health Care Chaplaincy
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