Improving access to palliative care clinical pastoral education.

Palliative care is interprofessional care for seriously ill people. Many clergy, religious leaders, and hospice and palliative care chaplains of color and minority religious backgrounds desire clinical palliative care education. This manuscript presents findings from a three-year quality improvement project which included the development of a palliative care specialty ACPE: The Standard for Spiritual Care and Education (ACPE) accredited program at an academic medical center. The program was designed to improve spiritual care provision in palliative care at the institution and to facilitate the participation of clergy and spiritual leaders of color and minority religious groups. Forty-six students participated in 53 400-h clinical pastoral education units. Strategies from medical education literature were employed to address obstacles to CPE participation including a racially and religiously diverse CPE advisory group, financial assistance, flexible learning (e.g. hybrid, asynchronous), and clinical placement agreements at places of employment. Upon completion of the program students provided written feedback, participated in a structured exit interview and completed a survey. Data were reviewed for common themes and results report student perceptions about the strategies utilized.

A implicação dos trabalhadores na política de assistência social brasileira / La implicación de los trabajadores en la política brasileña de asistencia social / The implication of workers in the brazilian social assistance policy

RESUMO. Esse artigo analisa a institucionalização da assistência social no Brasil e a implicação dos trabalhadores sociais neste campo. Partimos da narrativa de vida de Maria, que da experiência religiosa parte para a militância nos movimentos sociais e institucionaliza sua prática na ampliação da assistência social do governo de Luiz Inácio Lula da Silva em 2004. Neste contexto de luta e paixões, Maria investe em um saber prático que se torna o ponto de partida para a construção de uma sobreimplicação. Pelo método de narrativas de vida e da análise institucional, o trabalho contempla o campo micropolítico de um percurso biográfico para chegar a aspectos sócio-históricos da constituição da pasta no país e a construção de uma sensibilidade peculiar por parte dos trabalhadores. Essa sensibilidade, construída nas experiências anteriores ao trabalho social e potencializada no encontro com a política institucionalizada, pode adoecer os profissionais e favorecer a precarização da política pública quando alimenta um compromisso pessoal que se nega a enxergar a complexidade do que seja manter a seguridade social com competência e seriedade no país.

RESUMEN Analizamos la institucionalización de la Asistencia Social en Brasil y la implicación de los trabajadores sociales en este campo. Para esto, partimos de la narrativa de la vida de María, que a partir de la experiencia religiosa, comienza a ser militante en los movimientos sociales e institucionaliza su práctica en la expansión de la Asistencia Social del gobierno de Luiz Inácio Lula da Silva en 2004. En este contexto de lucha y pasiones, María invierte en conocimiento práctico que se convierte en el punto de partida para la construcción de una sobreimplicación. A través de la metodología de la historia de la vida y el análisis institucional, el trabajo contempla el campo micropolítico de una ruta biográfica para llegar a los aspectos sociohistóricos de la constitución de la pasta en el país y la construcción de una sensibilidad peculiar por parte de los trabajadores. Esta sensibilidad, basada en experiencias previas al trabajo social y mejorada en el encuentro con la política institucionalizada, puede enfermar a los profesionales y favorece la precariedad de las políticas públicas cuando alimenta un compromiso personal que se niega a ver la complejidad de lo que significa mantener la seguridad social con competencia y seriedad en el país.

ABSTRACT. This article analyses the institutionalization of Social Assistance in Brazil and the implication of social workers in this field. For this, we start from Maria's life narrative, which from religious experience, starts to militancy in social movements and institutionalizes its practice in the expansion of Social Assistance. Maria invests in practical knowledge that becomes the beginning for construction of an overimplication. Through theory and institutional analysis, the work contemplates the micropolitical field of a biographical path to reach socio-historical aspects of the constitution of the paste in the country and the building of a peculiar sensitivity on the part of the workers. This sensitivity, built on experiences prior to social work and enhanced in the encounter with institutionalized politics, can make professionals sick and favors the precariousness of public policy when it feeds a personal commitment that refuses to see the complexity of what it means to maintain social security with competence and seriousness in the country.

Evaluation of a Chaplain Residency Program and Its Partnership with an In-Patient Palliative Care Team.

In 2009 a Consensus Conference of experts in the field of spiritual care and palliative care recommended the inclusion of Board-certified professional chaplains with at least 1,600 hours of clinical pastoral education as members of palliative care teams. This study evaluates a clinical pastoral education residency program's effectiveness in preparing persons to provide spiritual care for those with serious illness and in increasing the palliative care team members' understanding of the chaplain as part of the palliative care team. Results showed chaplain residents felt the program prepared them to provide care for those with serious illness. It also showed that chaplain residents and palliative care team members view spirituality as an integral part of palliative care and see the chaplain as the team member to lead that effort. Suggested program improvements include longer palliative care orientation period, more shadowing with palliative care team members, and improved communication between palliative care and the chaplain residents.

Facilitating the provision of quality spiritual care in palliative care.

In 1948, Dame Cicely Saunders, the founder of the modem hospice movement, established a core principle of palliative care, Total Pain, which is defined as physical, spiritual, psychological, and social suffering. In 2009, a consensus panel (Puchalski, Ferrell, Virani, Otis-Green, Baird, Bull, et al., 2009) was convened to address the important issue of integrating spirituality in palliative care, which led to renewed efforts to focus on spiritual care as a critical component of quality palliative care. This project is a combination of advocacy for the importance of spiritual care, training chaplains, seminarians, community clergy, and healthcare professionals in palliative care, and creating a spiritual care curriculum which can be self-taught or taught to members of transdisciplinary teams.

Using online learning and interactive simulation to teach spiritual and cultural aspects of palliative care to interprofessional students.

BACKGROUND: To meet the complex needs of patients with serious illness, health professional students require education in basics aspects of palliative care, including how to work collaboratively on an interprofessional team. OBJECTIVES: An educational program was created, implemented, and evaluated with students in medicine, nursing, chaplaincy, and social work. Five learning objectives emphasized spiritual, cultural, and interprofessional aspects of palliative care. DESIGN: The program blended two sequential components: an online interactive, case-based learning module, and a live, dynamic simulation workshop. MEASUREMENTS: Content analysis was used to analyze students' free-text responses to four reflections in the online case, as well as open-ended questions on students' postworkshop questionnaires, which were also analyzed quantitatively. RESULTS: Analysis of 217 students' free-text responses indicated that students of all professions recognized important issues beyond their own discipline, the roles of other professionals, and the value of team collaboration. Quantitative analysis of 309 questionnaires indicated that students of all professions perceived that the program met its five learning objectives (mean response values>4 on a 5-point Likert scale), and highly rated the program and its two components for both educational quality and usefulness for future professional work (mean response values approximately>4). CONCLUSIONS: This innovative interprofessional educational program combines online learning with live interactive simulation to teach professionally diverse students spiritual, cultural, and interprofessional aspects of palliative care. Despite the challenge of balanced professional representation, this innovative interprofessional educational program met its learning objectives, and may be transferable for use in other educational settings.

Making our case(s).

Health care chaplaincy needs to develop a body of published case studies. Chaplains need these case studies to provide a foundation for further research about the efficacy of chaplains' spiritual care. Case studies can also play an important role in training new chaplains and in continuing education for experienced chaplains, not to mention educating health care colleagues and the public about the work of health care chaplains. Guidelines for writing case studies are described, herein, as is a project in which three experienced oncology chaplains worked together to write case studies about their work. Steps that chaplains, and professional chaplain organizations, can take to further the writing and publishing of case studies are described.

The competencies required by professional hospice palliative care spiritual care providers.

The Canadian Hospice Palliative Care Association (2002) identifies spiritual care of the dying and their families as a core service for Hospice Palliative Care programs. Yet, until the Spiritual Care Development Initiative of the Canadian Pallium Project, there was no published literature indicating systematic profiling of occupationally relevant core competencies or competency-based training programs specific to this specialized field of practice. This article describes a Canadian Community of Practice process to develop an occupational analysis-based competency profile for the Professional Hospice Palliative Care Spiritual Care Provider utilizing a modified Developing a Curriculum (DACUM) methodology. Competency profiles are important contributions to the development of curricula to train care providers who are recognized by other professions and by institutions as possessing the requisite theoretical and clinical expertise, particularly in academic tertiary care settings.

Religiosidade e espiritualidade no ensino de enfermagem: contribuição da gestão participativa para a integralidade no cuidado / Religiosity and spirituality in nursing education: participative management contribution for the care

A presente tese está inserida no núcleo de pesquisa Gestão em Saúde e Exercício Profissional em Enfermagem – GESPEN – da Escola de Enfermagem Anna Nery (EEAN/UFRJ), onde, tem-se como objeto de estudo: a contribuição da gestão acadêmica participativa na ampliação do tema religiosidade e espiritualidade, como conteúdo e ação no Projeto Pedagógico Curricular (PPC) de enfermagem, tendo a integralidade como fator essencial na prática de cuidar. O problema de pesquisa é: se é verdade que o gestor acadêmico garante discussões, relexões e ações sobre a religiosidade e a espiritualidade no PPC, em que momentos teóricos e práticos isso acontece? Se não acontece, na visão dos alunos, como eles evidenciam a ausência de discussões, reflexões e ações relacionadas à religiosidade e à espiritualidade na sua formação, na direção da integralidade do cuidado? Os objetivos do estudo são: identificar se os alunos participam da gestão acadêmica na construção, atualização e/ou avaliação do PPC; descrever o entendimento dos acadêmicos de enfermagem sobre oportunidades de discussões, reflexões e ações acerca da religiosidade e da espiritualidade no ensino teórico, prático e nos cenários do cuidado durante o curso de graduação em enfermagem, participando ou não do PPC; e apontar e discutir impasses, posibilidades e sugestões dos acadêmicos de enfermagem para aprofundar discussões, reflexões e ações sobre religiosidade e espiritualidade durante ensino teórico, prático e nos cenários do cuidado, com vistas à integralidade do cuidado e a gestão participativa...

This thesis was developed in the research nucleus of Health Management and Nursing Professional Practice –GESPEN – of the School of Nursing Anna Nery at the Federal University of Rio de Janeiro (EEAN/UFRJ), where the survey object is: the contribution of participatoryacademic management in the extension of the theme religiosity and spirituality, as content and action in the nursing Curricular Pedagogic Project (PPC), having the integrality as an essentialfactor in the practice of care. The research problem is: if it is true that the Academic Manager guarantees the discussions, reflections and actions about the religiosity and spirituality in the PPC, in which theoretical and practical moments does it happens? If it does not happen, by the students viewpoint, how do they evidence the lack of discussions, reflections and actions related with the religiosity and spirituality into their formation, in the direction of the integrality of care?The objectives of the survey are: identify if the students participate of the academic management in the construction, updating and/or evaluation of PPC; describe the understanding of nursingacademics about the opportunities for discussing, reflecting and acting about the religiosity and spirituality in the theoretical and practical teaching and in the care scenarios during nursinggraduation course, either participating or not in the PPC; point and discuss impasses, possibilities and suggestions of the nursing academics to deepen the discussions, reflections and actions about religiosity and spirituality during theoretical and practical teaching, and the care scenarios, with the view of care integrity and participative management.

Interprofessional education in palliative care: a pilot project using popular literature.

A need to introduce the concepts of death and dying to the medical and health sciences undergraduate curriculum was identified at the University of Ottawa, Ontario, Canada. As care of the terminally ill is complex and requires the collaborative involvement of a diverse group of health care professionals, an interprofessional educational approach was utilized to address this need. A seminar course was developed using popular literature as the basis for learning, and offered to first and second year medical students, fourth year nursing students and graduate students in spiritual care. The discussion of roles and the provision of care within the context of works of selected literature provided a focus that enabled the students to transcend their disciplinary barriers, and to better understand the perspectives and contributions that other team members bring to patient care. Evaluation findings suggest that meaningful interprofessional education can be introduced effectively to students either prior to or while they are maturing in their professional roles.

Pastoral care, spirituality, and religion in palliative care journals.

With the growth and development of palliative care, interest in pastoral care, spirituality, and religion also seems to be growing. The aim of this article is to review the topic of pastoral care, spirituality, and religion appearing in the journals of palliative care, between January 1984 and January 2002.

Clinical pastoral education: a physician's experience and reflection on the meaning of spiritual care in palliative care.

In this article a physician reflects on her experience as a chaplain intern and how this Clinical Pastoral Education experience led to a deeper understanding of spiritual care in the palliative setting.

The public debate on life and death choices: a response from a Jewish hospital chaplain.

Addresses the issue of life and death choices from the perspectives of a Jewish chaplain. Explores the tension between the law (Halachah) and experience or story (Aggadah) and the impact of that tension on lives and decisions. Cites persons and situations from biblical material, oral tradition, and modern times which illustrate the human struggle with these disputed issues. Explores different levels of pain and our understanding of and response to suffering. Invites reflection on the range of responses to pain that are humanly possible. Illustrates how meaning in life nurtures the desire to live. Claims this meaning aspect is not adequately addressed in the current dialogue. Focusses on the role of chaplains in listening and responding to persons and in helping to activate the impulse of hope. Suggests ways in which chaplains can be advocates for patients, prophetic voices within communities and institutions, and empowering of the gifts of others.

A terceira idade na Pastoral da criança de bem com a vida / The third age in the child pastoral

Manual que pretende refletir sobre o agente da Pastoral da Criança promovendo a valorização do ser humano