Advancing interprofessional education in communication.

OBJECTIVE: The objective of this training project is to develop and host Interprofessional Communication courses to improve interdisciplinary communication in oncology care. The initial national course was held in a virtual format and included pre- and post-course participant data. The curriculum was developed with support from the National Cancer Institute. METHODS: A virtual two-day course was held to equip nurses, social workers, and chaplains with vital communication skills in oncology practice, so that they could return to their home institutions and teach communication skills to other healthcare professionals, with the intention of making improved communication a quality improvement goal. Fifty-two participants were selected through an application process to attend the virtual course in two-person interprofessional teams (e.g., nurse and chaplain, or social worker and nurse). The Interprofessional Communication Curriculum was based on the National Consensus Project for Quality Palliative Care's eight domains of quality palliative care. The six online modules developed by the investigators were presented in lectures, supplemented by discussion groups, role plays, and other methods of experiential learning. RESULTS: Pre- and post-course results identified areas of communication, which are a priority for improvement by oncology clinicians. Participant goals identified specific strategies to be implemented by participants in their settings. SIGNIFICANCE OF RESULTS: The need for communication training was clearly demonstrated across professions in this national training course. Participants were able to apply course content to their goals for quality improvement in cancer settings.

Examining admission and formation outcomes for Catholic clergy applicants with the MMPI-2-RF: A prospective study.

Psychological evaluations of clergy applicants to the Catholic Church are an important gatekeeping mechanism during the admission process. However, limited research exists on the validity of assessments for this evaluative purpose and none have examined the predictive utility of the MMPI-2-RF to determine if an applicant will be accepted to formation, or if they ultimately ordained. This study fills that gap in the literature by investigating the predictive validity of MMPI-2-RF scales in 147 male applicants evaluated as part of their application for seminary or diaconate formation programs in a mid-sized Catholic diocese in the United States. Group analyses (e.g., Kruskal-Wallis tests) with admission status as the independent variable and MMPI-2-RF scales as the dependent variables yielded significant differences, most notably, those participants not admitted had higher mean scores on F-r, Fp-r, EID, RC7, THD, RC8, RC1, MLS, NUC, and JCP than the other three groups. Relative risk ratios were estimated for all MMPI-2-RF scales, indicating that higher scores are generally associated with a lower likelihood of admission and, ultimately, ordination. Limitations and future directions of research are also discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Study of Shadowing Experiences among Chaplains in the Coleman Palliative Medicine Fellowship.

While shadowing is a relatively common practice in the education of many health professionals, it is not widely used in chaplaincy education. Findings from our qualitative study of 12 chaplains who participated in the Coleman Palliative Medicine Training Program suggest it may offer benefits for practicing chaplains. In interviews with seven fellows who shadowed more experienced palliative care (PC) chaplains and the five mentors who were shadowed at their work settings, participants reported opportunities for mutual learning, self-reflection, and collegiality. Fellows observed how members of a PC team collaborate and contribute equally to the care of patients. Mentors found shadowing was a rare opportunity to share their chaplaincy practice with colleagues. It helped them to appreciate different aspects of their work settings and to distinguish between PC and generalist chaplaincy. We discuss the challenges participants experienced while shadowing and offer recommendations for incorporating the practice more widely into chaplaincy education.

Self-compassion and healthcare chaplaincy: a need for integration into clinical pastoral education.

Clinical chaplains are exposed to varying degrees of suffering and are not exempt from suffering themselves. This study took a phenomenological approach to examining self-compassion among 11 clinical chaplains, all of which had suffered from personal and/or professional hardships while providing spiritual care to medical staff, patients, and families. The three elements of self-compassion are mindfulness, self-kindness, and common humanity. Results showed that clinical chaplains' understanding of the aspects of self-compassion are limited or non-existent. Participants in this study ardently shared their experiences as they related to self-care activities during times of personal hardship. However, the intentional implementation of self-compassion practice was not displayed in these narratives. The need for education in this area would prove to enhance self-awareness and overall self-care within the profession of clinical chaplaincy.

Meditation app alleviates burnout and builds resilience for chaplains in hospices for older adults in Asian and African cities.

This article reports a one-year study examining the effect of a smartphone meditation app (M-App) in alleviating burnout and promoting resilience among chaplains working in hospices of older adults in Asian and African cities (N1 = 96; N2 = 85). Results indicated that chaplains who used the M-App exhibited lesser emotional exhaustion and depersonalization as burnout markers and higher personal achievement and resilience as compared to leisure app (L-App) users. The M-App was effective (Cohen's d range = 3.08-5.07, p = .001) for the intervention cohort. Male chaplains, highly qualified, attached to assisted living hospices, who used the M-App once-twice a day, perused both videos and learning sessions and self-practiced regularly, reported lower emotional exhaustion and depersonalization and higher personal achievement and resilience post-test. M-App usage behavior mediated the relationship between demographic and hospice related moderators and outcomes.

Love, Judgement and HIV: Congregants' Perspectives on an Intervention for Black Churches to Promote Critical Awareness of HIV Affecting Black Canadians.

We assess participants' experience of Black Pastors Raising Awareness and Insight of Stigma through Engagement (Black PRAISE), an intervention for Black churches to promote critical awareness of HIV affecting Black Canadian communities. We used a community-based participatory approach to implement Black PRAISE among six churches in the Greater Toronto Area and Ottawa, in October-November 2016. For the intervention, congregants received a booklet with validated HIV-related information, attended a sermon on compassion and justice, viewed a short film on HIV-related stigma, and completed baseline and follow-up surveys to evaluate the effectiveness of the intervention. We then conducted in-depth interviews with 18 pastors and congregants from the six churches to explore how they experienced the intervention. Three major themes emerged from an iterative exploration of the thematic content of the interviews: the beneficial impact of the intervention; reconciling the moral and theological issues of their faith with the social reality of HIV and stigma; and perspectives on future stigma reduction efforts. Participants spoke approvingly about Black PRAISE and supported stigma reduction but acknowledged uncertainties about their capacity to actualise their commitment. The main overarching lessons from Black PRAISE are as follows: first, our results support a community-based participatory approach to productively engaging Black congregations in stigma reduction and health promotion; second, promising or successful interventions incorporate multiple components to promote critical awareness about the specific health issue for Black life and wellbeing; and third, interventions are more likely to succeed if they support critical reflection on the underlying conceptual issues, implicit assumptions and belief systems among the professional and lay stakeholders.

Child Sexual Abuse by Catholic Priests, Deacons, and Male Members of Religious Orders in the Authority of the German Bishops' Conference 1946-2014.

This study explores the extent of sexual abuse of minors by members of the Catholic Church in Germany. It is the first comprehensive study to examine this extent in a European country. The goals of this study are as follows: (a) to analyze whether the extent and characteristics of sexual abuse in a European country are comparable to those in the United States and Australia and (b) how discrepancies can be explained. The personnel files of 38,156 Catholic Priests, deacons, and male members of religious orders in the authority of the German Bishops' Conference were analyzed. The study period lasted from 1946 to 2014. All 27 German dioceses took part in this study. A total of 4.4% of all clerics (N = 1,670) from 1946 to 2014 were alleged to have committed sexual abuse, and 3,677 children or adolescents were identified as victims. These results are similar to those from comparable studies in the United States. Sexual abuse of minors within the authority of the Catholic Church seems to be a worldwide phenomenon.

Paraphilias among Roman Catholic priests: what we know, and do not know, about sexual clergy-abusers of minors. / Parafilie wsród ksiezy Kosciola rzymskokatolickiego: co wiemy, czego i nie wiemy, o duchownych wykorzystujacych seksualnie maloletnich.

The issue of sexual abuse of minors in the Catholic Church is widely discussed in the media. Nevertheless, the term ?priest-pedophile'has been used inaccurately to identify perpetrators. There is very little research directly dealing with this group of offenders among Catholic clergy, and we do not yet have any theory that would adequately explain this type of behavior. Attempts to psychologically characterize priests who sexually abuse minors have brought limited success so far. The purpose of this article is to present the most important issues and clinical dilemmas related to the diagnosis and treatment of paraphilias among Catholic clergy, signifying similarities and differences between clergy and other perpetrators of sexual offenses against minors, present typology of sexual offenders among priests, and discuss therelationship of victims' gender with sexual orientation and celibacy of perpetrators. The author demonstrates that using the term ?priest-pedophile' is not only misleading, but is sometimes used to deliberately mislead. On the one hand, to create a moral panic effect, suggesting that the Catholic clergy is at increased risk of this type of crime. On the other hand, indicating gender and age of the most of their victims, suggesting that people responsible for this kind of abuse among Catholic clergy are homosexual priests and thus select a scapegoat responsible for the problems of the Church institution.

Chaplaincy Care in the MICU: Describing the Spiritual Care Provided to MICU Patients and Families at the End of Life.

BACKGROUND: Gravely ill patients admitted to the intensive care unit (ICU), and their families experience acute spiritual and existential needs and often require complex decisions about their care. Little is known about what constitutes chaplaincy care for patients or families in ICUs. Chaplains report that participation in medical decision-making is part of their role. OBJECTIVE: To describe the spiritual care provided to patients and their families in the ICU. METHODS: This was a retrospective observational study of spiritual care for patients and families in the medical ICUs (MICUs) at 4 medical centers over a 3-month period. Inclusion criteria were death in the MICU or discharge to palliative care or hospice. Measures included medical, treatment, and spiritual care information (number of visits, length of visit, chaplain categories, and type of spiritual care provided). RESULTS: Of the 254 patients, 197 (78%) received a total of 485 spiritual care visits. Seventy-seven percent of visits included provision of emotional/spiritual support; only 15% included decision-making support such as family meetings or goals-of-care conversations. The proportion receiving spiritual care increased as patients neared death or discharge. Staff chaplains were involved in goals-of-care conversations to a greater extent than student or part-time chaplains (P < .05). CONCLUSION: Spiritual care was provided to most patients and/or families at the end of life. Low chaplain involvement in decision-making in the MICU suggests opportunities to improve chaplains' contributions to ICU care.

Prisoners Helping Prisoners Change: A Study of Inmate Field Ministers Within Texas Prisons.

Research on incarcerated offenders trained to help prisoners change is rare because programs that equip inmates with practical capacities for helping others rehabilitate in prison hardly exist. An exception is the Field Ministry program in Texas, which enlists inmates who have graduated from a prison-based seminary to work as "Field Ministers" and serve other inmates in various capacities. We hypothesize that inmate exposure to Field Ministers is inversely related to antisocial factors and positively to prosocial ones. We applied manifest-variable structural equation modeling to analyze data from a survey of a random sample of male inmates at three maximum-security prisons where the Field Ministry program operated. We found that inmates exposed more frequently to the Field Ministry and for a longer time period tended to report lower levels of criminological risk factors and aggressiveness and higher levels of virtues and predictors of human agency as well as religiosity and spirituality.

A New Perspective on Spiritual Care: Collaborative Chaplaincy and Nursing Practice.

Spirituality is a key focus and ethical obligation of nursing practice, but many nurses express uncertainty or discomfort with this aspect of their role. The purpose of this article is to explore the domains of religion, spirituality, and culture as commonly conceptualized by chaplains, as a framework for nurses to provide spiritual care interventions to patients in acute care hospitals. Using anecdotes and illustrations from palliative care practice, this article discusses the enhanced benefits to patients and families when spiritual needs are addressed, with specialty-level chaplain interventions, primary spiritual interventions provided uniquely by nurses, or interventions that require the cooperation of both professions. Lessons learned from the inpatient palliative care team experience can also apply to chaplaincy and nursing care for patients in settings beyond the acute care hospital and in disciplines beyond palliative care.

Research Priorities for Health Care Chaplaincy in The Netherlands: A Delphi Study Among Dutch Chaplains.

The aim of this study was to identify research priorities for health care chaplaincy in The Netherlands according to practicing chaplains and chaplaincy leaders. To this end, a two-round Delphi study was conducted. The first round in which participants were asked to list at least three research priorities was completed by 249 respondents. Through content analysis, the resulting 811 priorities were merged into 54 research topics in 10 domains. In the second round, 179 respondents ranked these topics on a Likert scale from 1 to 5 (low priority-high priority) from the perspective of the patient/client, the organization, and the profession. Based on the mean score of each topic, five research priorities were identified: (a) to investigate the effect of chaplain care according to the patient/client; (b) to determine the patients'/clients' need(s) for chaplaincy; (c) to investigate the effect of chaplain care on the patient/client; (d) to identify possibilities for chaplaincy practice in outpatient care; and (e) to investigate how to develop a stronger profile for chaplaincy in The Netherlands. These priorities resonate with research on this topic from other countries and indicate directions for future research efforts to improve chaplaincy care.

Potential of technology to improve the availability and use of health information on cancer subjects for clergy from rural communities.

BACKGROUND: Cancer is a leading cause of death around the world and often is a chronic long term disease. This calls for an expanded workforce to include non-traditional health care providers. OBJECTIVE: To determine effectiveness of a cancer information training project with clergy from selected rural Appalachian areas to improve comfort and willingness to work as part of the cancer health care team. METHODS: Clergy were trained in the consumer health database of the National Library of Medicine MedlinePlus.gov. Exercises were required that were done using an iPad tablet with an online curriculum. They were also taught how to do a population health assessment of their particular area and develop a health ministry for their church. RESULTS: Three key elements were confirmed that would enable replication of the pilot: access to medlineplus, programmed learning modules using mobile technology such as iPads, and staff support including librarians and medical staff. With these key elements, the cancer project is potentially replicable with other groups beyond clergy. CONCLUSION: Knowledge about population health, built on new awareness and topical health knowledge, and using new skills to identify relevant information and library resources, could open minds and enhance community support for preventive and medical interventions.

Rural Black Pastors: the Influence of Attitudes on the Development of HIV/AIDS Programs.

This exploratory research addressed the question, among rural Mississippi African American Baptist pastors, what is the impact of attitudes toward HIV/AIDS on the development of HIV/AIDS programs in the church? It was hypothesized that empathetic attitudes toward HIV make programming more likely. The study used Froman and Owen's AIDS Attitude Scale (AAS) and a demographic questionnaire, which included a measure that assessed potential program development. A sample of more than 300 African American pastors participated. The findings suggested that there is a significant relationship between rural Mississippi African American Baptist pastors' empathetic attitudes toward AIDS and their willingness to develop an HIV/AIDS program.

The Provision of Clergy Health Resources by Faith-Based Organizations in the USA.

The purpose of this study was to describe practices and perceptions related to promoting clergy health among a national sample of denomination-level faith-based organizations (FBOs) (N = 154). Stress was identified as the top health-related issue facing clergy. The most commonly offered health resource was employer-sponsored health insurance. Lack of financial resources was the most common barrier to providing health resources for clergy. This study highlights potential priorities for denomination-level FBOs interested in providing health resources for clergy.

Training Healthcare Chaplains: Yesterday, Today and Tomorrow.

This article invites theological school educators, clinical pastoral education educators, representatives of the professional healthcare chaplaincy organizations, and social scientists to begin a shared conversation about chaplaincy education. To date, we find that theological educators, clinical educators, professional chaplains, and the healthcare organizations where they work are not operating from or educating toward a common understanding of what makes healthcare chaplains effective. Before we identify five key questions that might help us be in shared conversation and move towards educating the most effective chaplains, we briefly describe the history of education for healthcare chaplaincy. We then describe what we learned in interviews in 2018 with 21 theological and 19 clinical educators who are educating healthcare chaplains in theological schools and clinical pastoral education residency programs, year-long educational programs in hospitals and other settings that focus on preparing people for staff chaplain jobs. Their different approaches and frames inform the five questions with which we conclude.

Organizational readiness for wellness promotion - a survey of 100 African American church leaders in South Los Angeles.

BACKGROUND: Churches are an important asset and a trusted resource in the African American community. We needed a better understanding of their readiness to engage in health promotion before launching a large-scale health promotion effort in partnership with South Los Angeles churches. METHODS: In 2017, we conducted surveys with leaders of 100 churches. Surveys were conducted face-to-face (32%) or by telephone (68%) with senior pastors (one per church) and lasted on average 48 min. We compared small (less than 50 active members), medium (50-99 active members) and large churches (at least 100 active members), and assessed which church characteristics were associated with the implementation of wellness activities. RESULTS: Medium and large churches conducted significantly more wellness activities than small churches and were more likely to have wellness champions and health policies. Regardless of church size, insufficient budget was the most commonly cited barrier to implement wellness activities (85%). A substantial proportion of churches was not sure how to implement wellness activities (61%) and lacked volunteers (58%). Forty-five percent of the variation in the number of wellness activities in the last 12 months was explained by church characteristics, such as size of congregation, number of paid staff, leadership engagement, having a wellness ministry and barriers. CONCLUSIONS: Many churches in South Los Angeles are actively engaged in health promotion activities, despite a general lack of resources. We recommend a comprehensive assessment of church characteristics in intervention studies to enable the use of strategies (e.g., stratification by size) that reduce imbalances that could mask or magnify study outcomes. Our data provide empirical support for the inner settings construct of the Consolidated Framework for Implementation Research in the context of health promotion in African American churches.

Spiritual Care at the End of Life: Does Educational Intervention Focused on a Broad Definition of Spirituality Increase Utilization of Chaplain Spiritual Support in Hospice?

Background: Research shows that religion and spirituality are important when persons cope with serious and life-threatening illness. Patients who receive good spiritual care report greater quality of life and better coping, and such support is strongly associated with greater well-being, hope, optimism, and reduction of despair at end of life. Despite these benefits, evidence shows that many patients and caregivers (P/C) refuse spiritual care when a hospice team offers it, possibly resulting in unnecessary suffering. Objective: To better understand what contributes to spiritual support acceptance in hospice care. Design: Quasi-experimental quantitative study. Setting/Subjects: 200 patients admitted to hospice. Measurements: Participants were divided equally into intervention and control arms. Control participants received standard information about the availability of chaplain support and an offer for referral to chaplain services. Intervention participants received educational intervention that explained hospice chaplain services and the evidence-based benefits of spiritual support. The association of chaplain acceptance was measured with treatment group, patient age, disease, church affiliation and support, sex, bereavement risk, and place of residence. Results: Among intervention participants, 64 (64%) accepted spiritual support versus 52 (52%) of control participants. The intervention arm's acceptance rate was higher than the control arm after adjustment for other variables. The variables associated with acceptance were age, primary diagnosis, and place of residence. Conclusions: This research suggests that educational intervention that explains spiritual care in hospice and its benefits contributes importantly to greater acceptance and allows P/C to gain the benefits of spiritual support during end-of-life care.

Why the Focus of Clerical Child Sexual Abuse has Largely Remained on the Catholic Church amongst Other Non-Catholic Christian Denominations and Religions.

The current study considers reasons for the consistent focus of academic research and mainstream media on clerical child sexual abuse (cCSA) largely within the Roman Catholic Church, seeming to ignore cCSA in other Christian denominations and religions. This study includes an analysis of traditional mainstream media and case reports on cCSA in non-Catholic churches and other religious faiths. The authors highlight the inadequacy of research and identify a wide range of gaps in this so far neglected area. Commonalities of cCSA and institutional responses are identified across denominations and religions, and reasons for the apparent over focus on the Catholic Church are discussed. The mains potential reasons identified were: (a) the centralized nature of the Church's universal organizational stature and management structure; (b) the anti-Catholic political and media bias in Protestant-dominated developed countries; (c) secular legal systems with access to powerful lawyers and insurance companies to locate responsibility at organizational level in order to seek compensation and finally; (d) the organized institutional power exercisable by respective bishops to silence victims. Future research needs to move beyond analysis of existing academic literature, press, and case review reports to comparative empirical studies across denominations and religions.

Spiritual Care for Everyone? An Analysis of Personal and Organizational Differences in Perceptions of Religious Diversity among Spiritual Caregivers.

In multicultural and multifaith societies spiritual caregivers increasingly meet clients with diverse (non-)religious or spiritual orientations. We investigate how this religious and spiritual (R/S) diversity is dealt with by spiritual caregivers working in healthcare settings, the military, and prisons. Based on a survey among spiritual caregivers (n = 208) in a secularized, European country (The Netherlands), this study shows how spiritual caregivers' personal as well as organizational factors relate to attitudes to R/S diversity. Spiritual caregivers who draw from several religious traditions in their lives have more positive views on spiritual caregiving to patients with another R/S orientation than theirs than those drawing from none or a singular tradition. Furthermore, authorization by a religious or Humanistic institution seldom relates to how R/S diversity is perceived, but the position of spiritual caregivers within various organizational settings and the way in which spiritual caregivers work does.