Defining the Context for Best Practices: Institutional Setting for Clinical Pastoral Care in Estonia.

The current article aims to offer an informational basis for creating an adaptable model of spiritual support provision for Estonian health care institutions. The study addresses Estonian medical staff's knowledge about and attitudes towards spiritual support. The data originate from a quantitative research conducted in 19 Estonian hospitals during 2015-2016. The results show a good will for interdisciplinary co-operation, and pastoral caregiver is expected to be a part of the staff. The fact that spiritual support is not financed by the state budget funds raises the question about explaining the benefits of spiritual support to the hospital's or clinic's management.

The Evolution of Research Paradigms in Pastoral/Spiritual Care, Counseling, and Education.

This partially autobiographical article is presented as a chapter in the narrative of the evolution of research methodology in the social sciences and the impact that evolution has had on pastoral/spiritual care research as the author has experienced and observed it during the latter part of the 20th century and the early years of the 21st century.

Language and practice changes in Canadian and US specialized pastoral care and counseling: a conversation.

On August 20, 2013, Terry Bard, John Carr, and Steve Ivy had a 50-minute conversation about the shift that has been taking place in Canada and the United States in the practice, and the language about that practice, of persons and professional associations that have historic roots in the modern pastoral care and counseling movement. The conversation was digitally recorded, by agreement among the three participants, and is posted on the internet as a stimulus to further conversation.

Ethics in pastoral care and counseling: a contemporary review of updated standards in the field.

This article reviews ethical responsibilities that must be considered when engaging in pastoral care, counseling, and psychotherapy. It discusses important contemporary issues counselors will want to contemplate in pursuing a high quality of care in their counseling practices. Examples and case studies are provided. Readers will be able to: Understand the function of ethical standards in the practice of counseling Be able to differentiate between pastoral care, pastoral counseling, and pastoral psychotherapy and their ethical implications Understand the importance of identifying one's limitations in counseling situations and how to proceed under such circumstances. Understand the need for pastoral counselors to attain the necessary credentials for practice in the area of counseling they intend to undertake. Become aware of the legal requirements when engaged in a counseling relationship.

Measuring effectiveness of a spiritual care pedagogy in nursing education.

Nurses have long recognized the importance of spiritual care in nursing practice as promoting the integration of meaning and purpose in life. More recently, both the American Nurses Association incorporates spiritual care in the Scope and Standards of Nursing Practice and the American Association of Colleges of Nursing has integrated spiritual care in the Essentials of Baccalaureate Education. However, research suggests that nurses do not know how to provide spiritual care. This study developed and tested a spiritual care pedagogy. In phase I, researchers designed a spiritual care educational and reflective program based on the Burkhart/Hogan theory of spiritual care in nursing practice, incorporating face-to-face and on-line components. In phase 2, the effectiveness of this program was measured in a pre-post test, randomized controlled trial with senior nursing students during their capstone clinical immersion course (n=59). Findings revealed a statistically significant increase in students' perceived ability in providing spiritual care, particularly in complex family clinical situations. Findings also indicated a significant increase in the student's use of reflective practices, which students found to help support them during stressful times. This study translates nursing theory and research into a successful pedagogy.

An evidence base for a palliative care chaplaincy service in Northern Ireland.

Palliative care encompasses spiritual as well as physical, social and psychological aspects. Spiritual care has been identified as a key concern of dying patients. During an audit of the Northern Ireland Hospice chaplaincy service against the national Standards for Hospice and Palliative Care Chaplaincy (2003), 62 patients' spiritual needs along with their interactions with the hospice chaplains were assessed by using a questionnaire survey and reviewing data recorded on their pastoral care notes. Findings suggest that the Standards were useful for assessing and addressing spiritual needs. Access to the chaplaincy service (Standard 1) was partially met and Standard 2's spiritual criteria were fully met. The participants, of whom 92% had a faith in God or a Higher Being, highlighted their top six spiritual needs as: to have the time to think; to have hope; to deal with unresolved issues; to prepare for death; to express true feelings without being judged; to speak of important relationships. The majority of the participants (82%) felt their spiritual needs had been addressed and viewed their interaction with the chaplaincy service positively. Recommendations were made relating to improve communication of chaplaincy services.

A competency model for the assessment and delivery of spiritual care.

The delivery of spiritual and religious care has received a high profile in national reports, guidelines and standards since the start of the millennium, yet there is, to date, no recognized definition of spirituality or spiritual care nor a validated assessment tool. This article suggests an alternative to the search for a definition and assessment tool, and seeks to set spiritual care in a practical context by offering a model for spiritual assessment and care based on the individual competence of all healthcare professionals to deliver spiritual and religious care. Through the evaluation of a pilot study to familiarize staff with the Spiritual and Religious Care Competencies for Specialist Palliative Care developed by Marie Curie Cancer Care, the authors conclude that competencies are a viable and crucial first step in 'earthing' spiritual care in practice, and evidencing this illusive area of care.

The challenge of providing spiritual care.

Spirituality is an essential element of holistic nursing and nurses need the knowledge and confidence to address spiritual issues with patients. This paper describes the development of a tool to help with broaching this sensitive aspect of care. It argues that nurses need to examine their own spiritual needs in order to be able to help others.

Cultural diversity in pastoral care.

Fukuyama and Sevig are counseling psychologists who have a particular interest in the integration of spirituality into multicultural counseling and training. In this article the authors address the complexity of integrating religious and cultural diversity and spirituality into chaplaincy care in the context of an increasingly diverse society. By posing a series of questions, the authors systematically clarify definitions and meanings of culture, spirituality, cultural diversity and multiculturalism, multicultural and spiritual competencies in counseling, and ethical considerations. The authors discuss clinical applications in the context of a "spirituality and health movement," and provide suggestions for continuing professional development. The authors support the notion that multicultural engagement is spiritually synergistic, and encourage health care providers to communicate across professional disciplines to broaden and enrich discourse on these topics.

Spirituality in health: the role of spirituality in critical care.

Caring for critically ill patients requires that physicians and other health care professionals recognize the potential importance of spirituality in the lives of patients, families, and loved ones and in their own lives. Patients and loved ones undergo tremendous stress and suffering in facing critical illness. Professional caregivers also face similar stress and sadness. Spirituality offers people away to understand suffering and illness. Spiritual beliefs can also impact how people cope with illness. By addressing spiritual issues of patients, loved ones, and ourselves, we can create more holistic and compassionate systems of care.