RESUMEN
There is interest in chaplains devoted to outpatient cancer care, informed by a growing body of research as well as recommendations of accreditors. Simultaneously, a growing share of U.S. healthcare is faith-based and possesses a foundational interest in religious/spiritual (R/S) care due to institutional culture. In that milieu, few articles describe how religious organizational cultures influence the creation and implementation of FTEs intended to meet the evidence-based recommendations of accreditors. This is a lacuna, given that board certified chaplains are measured on their ability to integrate spiritual care into the life and service of their institutions. In response, this article describes the creation and implementation of two chaplain positions devoted to a group of outpatient cancer clinics in a large Catholic healthcare system. This includes lessons learned when navigating R/S aspects of organizational cultures while implementing and executing chaplain practice to meet accreditor recommendations.
Asunto(s)
Servicio de Capellanía en Hospital , Clero , Humanos , Servicio de Capellanía en Hospital/organización & administración , Neoplasias/terapia , Cuidado Pastoral/organización & administración , Atención Ambulatoria/organización & administración , Instituciones Oncológicas/organización & administración , Catolicismo , Organizaciones Religiosas/organización & administración , Cultura OrganizacionalRESUMEN
OBJECTIVES: This pilot study explores how healthcare leaders understand spiritual care and how that understanding informs staffing and resource decisions. METHODS: This study is based on interviews with 11 healthcare leaders, representing 18 hospitals in 9 systems, conducted between August 2019 and February 2020. RESULTS: Leaders see the value of chaplains in terms of their work supporting staff in tragic situations and during organizational change. They aim to continue to maintain chaplaincy efforts in the midst of challenging economic realities. CONCLUSIONS: Chaplains' interactions with staff alongside patient outcomes are a contributing factor in how resources decisions are made about spiritual care.
Asunto(s)
Actitud del Personal de Salud , Servicio de Capellanía en Hospital/organización & administración , Toma de Decisiones , Liderazgo , Cuidado Pastoral/organización & administración , Rol Profesional , Espiritualidad , Adulto , Anciano , Clero , Femenino , Humanos , Relaciones Interprofesionales , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Servicios de Salud del Trabajador/organización & administración , Selección de Personal/organización & administración , Admisión y Programación de Personal/organización & administración , Proyectos Piloto , Estados UnidosRESUMEN
Since the publication of Chaplain Rhonda Cooper's case study in 2011, chaplain case studies have become part of the chaplaincy research agenda. Chaplains from North America, Europe and Australia have published almost 30, and this article offers a first look at the findings that are emerging from these cases. Locating chaplains' case studies at the juxtaposition of 'outcome oriented chaplaincy' and so-called 'process-oriented chaplaincy', the article argues chaplains' case studies dissolve what is a false dichotomy. Utilizing an analytical framework provided by ongoing debate among psychotherapists, the article argues that the emerging data suggests chaplaincy manifests features that are common to psychotherapy but also that there are significant factors specific to chaplaincy. From this analysis, the article observes the case studies paint a picture of chaplaincy care as a religious intervention. However, contemporary chaplaincy exists within a rapidly changing context, where increasing numbers of people are religiously unaffiliated. The article concludes by suggesting that chaplains' case study research poses significant theological, ethical and existential questions to chaplaincy about how to respond to its changing context. The article ends with a call for chaplaincy care to be radically and explicitly remodeled as care for the human spirit regardless of religious affiliation.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Investigación sobre Servicios de Salud , Humanos , Estudios de Casos OrganizacionalesRESUMEN
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.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Conducta Cooperativa , Cuidados Paliativos/organización & administración , Cuidado Pastoral/organización & administración , Pautas de la Práctica en Enfermería/organización & administración , Espiritualidad , Actitud del Personal de Salud , Clero/estadística & datos numéricos , Humanos , Relaciones Interprofesionales , Rol de la Enfermera/psicología , Grupo de Atención al Paciente/organización & administración , Atención Dirigida al Paciente/organización & administración , Rol ProfesionalRESUMEN
Hiltner's shepherding perspective offered a primary reference point for pastoral theologians. This paper examines how the reconciling function of that perspective guides the care proceeding from it for Black persons experiencing medical crises. I analyze connections in the work of Archie Smith with Black persons involved in the healthcare system to show how Black persons draw upon spiritual resources and other resources implicit to the Black community itself in order to reconcile lived experiences with sickness.
Asunto(s)
Negro o Afroamericano/psicología , Cuidado Pastoral/métodos , Religión y Medicina , Espiritualismo/psicología , Espiritualidad , Servicio de Capellanía en Hospital/organización & administración , HumanosRESUMEN
BACKGROUND: Although attending to spiritual and religious needs is part of high quality care of pediatric cancer patients, oncology clinicians may not understand the role of the chaplain, resulting in underutilization of resources and failure to fully integrate the chaplain into the clinical team. We provide a description of what the chaplain does in the care of pediatric oncology patients. METHODS: We conducted a qualitative content analysis of chaplain chart notes over a one-year period on the pediatric oncology service at a freestanding children's hospital. Using criteria designed to capture multiple potential factors in chaplain referral, we selected 30 patients for thematic analysis. RESULTS: In 2016, 166 pediatric patients were diagnosed with cancer and received ongoing care at our institution. From the 30 patients selected, 230 chaplain encounters were documented in the medical chart. Three major themes emerged. (1) The chaplains provided a rich description of spiritual and psychosocial aspects of the patient and family's experience; (2) chaplains provided diverse interventions, both religious and secular in nature; and (3) chaplains provided care within a longitudinal relationship. All three themes depend on the empathic listening by a chaplain. CONCLUSIONS: The chaplains' observations about patient and family beliefs, experiences, and emotional/spiritual states have the potential to inform the interdisciplinary care of the patient. Chaplain documentation provides insight into how spiritual care interventions and close relationships may promote patient and family well-being. In future work, we will explore how to give voice to their insights in caring for pediatric oncology patients.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Clero/psicología , Documentación/normas , Relaciones Interprofesionales , Neoplasias/terapia , Cuidados Paliativos/psicología , Cuidado Pastoral/métodos , Adolescente , Adulto , Niño , Preescolar , Conducta Cooperativa , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Neoplasias/diagnóstico , Neoplasias/psicología , Grupo de Atención al Paciente , Pronóstico , Espiritualidad , Adulto JovenRESUMEN
In the Intensive Care Unit (ICU), family members experience psychological and spiritual distress as they cope with fear, grief, and medical decisions for patients. The study team developed and pilot tested a semistructured chaplain intervention that included proactive contact and spiritual assessment, interventions, and documentation. An interdisciplinary team developed the intervention, the Spiritual Care Assessment and Intervention (SCAI) Framework. Three chaplains delivered the intervention to surrogates in two ICUs. There were 25 of 73 eligible patient/surrogate dyads enrolled. Surrogates had a mean age of 57.6, were 84% female and 32% African American. The majority (84%) were Protestant. All received at least one chaplain visit and 19 received three visits. All agreed they felt supported by the chaplains, and qualitative comments showed spiritual and emotional support were valued. A semistructured spiritual care intervention for ICU surrogates is feasible and acceptable. Future work is needed to demonstrate the intervention improves outcomes for surrogates and patients.
Asunto(s)
Servicio de Capellanía en Hospital , Familia/psicología , Mejoramiento de la Calidad/organización & administración , Servicio de Capellanía en Hospital/métodos , Servicio de Capellanía en Hospital/organización & administración , Estudios de Factibilidad , Femenino , Humanos , Unidades de Cuidados Intensivos/organización & administración , Masculino , Persona de Mediana Edad , Grupo de Atención al Paciente , Desarrollo de Programa , EspiritualidadRESUMEN
Research interest in hospital chaplaincy has increased, in part because it is believed to contribute to the development of just models of religious pluralism. This research note brings attention to hospital chaplaincy in Sweden, a country where religious diversity has substantially increased due to migration but where research in hospital chaplaincy is scarce. In order to advocate for future research, this research note describes the organization of hospital chaplaincy in Sweden, presents new analyses of official data showing its extent and religious composition, and proposes that the organization of hospital chaplaincy in this country needs to be re-considered now that religious diversity is a given. Showing that hospital chaplaincy in this country is still under the overbearing influence of Christianity, this research note argues that there is a need for research that sheds light on the asymmetrical power relations that exist and that paves the way for innovations in religious pluralist models for health care chaplaincy.
Asunto(s)
Servicio de Capellanía en Hospital , Diversidad Cultural , Religión y Medicina , Servicio de Capellanía en Hospital/métodos , Servicio de Capellanía en Hospital/organización & administración , Servicio de Capellanía en Hospital/estadística & datos numéricos , Hospitales/estadística & datos numéricos , Humanos , Religión , SueciaRESUMEN
Chaplains, like professionals in a range of industries, have long sought to maintain and build occupational power by articulating their professional mandate and advocating for their work. I describe how leaders of the Association of Professional Chaplains and its predecessor organizations used multiple strategies to articulate and re-articulate their professional mandate between 1940 and the present to become a companion profession, one that comes alongside another without seeking to challenge its jurisdiction. I find chaplains seeking to develop an economic base, aligning interests across distinct segments of the profession and creating new professional associations, lobbying for legislative support, and offering their services in institutional voids. They further adopted the language of healthcare around questions of identity, charting, and accreditation and, chaplains used not just the frameworks but the methods of healthcare-evidence based research-to try to demonstrate their value. This history can help chaplains and chaplaincy leaders today to form a more comprehensive sense of their history and think more strategically regarding how to make the case for their profession going forward.
Asunto(s)
Clero , Servicio de Capellanía en Hospital/historia , Servicio de Capellanía en Hospital/organización & administración , Clero/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Profesionalismo/historia , Sociedades Médicas/historia , Estados UnidosRESUMEN
There is increasing pressure to provide an evidence base for chaplaincy with children and young people. This is an underresearched area, and current evidence is often anecdotal. Advocate Health Care in Chicago (funded by the Templeton Foundation working in partnership with the Health Care Chaplaincy Network) developed a 100-item taxonomy that was the starting point for a wider international initiative in developing a taxonomy for use in health care chaplaincy. The team at Birmingham Children's Hospital is part of this wider project and have sought to adapt and develop the original taxonomy for use in a specialist pediatric hospital. The Advocate structure of intended effect (why chaplains do what they do), method (what they do), and intervention (how they do it) was adapted by adding items generated from the chaplaincy team's research, writing, and experience. A total of 80 taxonomy charts were collected from 12 chaplaincy team members representing three world faiths. Quantitative data from the chart were analyzed and summarized. The findings were subsequently reviewed by the research team and a revised version of the taxonomy was produced based on the frequency of use of the additional items.
Asunto(s)
Servicio de Capellanía en Hospital , Defensa del Niño , Defensa del Paciente , Servicio de Capellanía en Hospital/clasificación , Servicio de Capellanía en Hospital/organización & administración , Niño , Preescolar , Inglaterra , Femenino , Hospitales Pediátricos , Humanos , Lactante , Recién Nacido , Masculino , Proyectos Piloto , ReligiónRESUMEN
This article seeks to reconstruct how the process of institutionalization of a presbytery of non-Catholic chaplains developed as a way to adapt and interact with public institutions in Argentina, particularly health care institutions. For this purpose, qualitative interviews with religious actors trained in bioethics were carried out, in addition to participant observation in training spaces and conferences on health and bioethics and documentary analysis of training material and declarations of religious actors on issues of health and bioethics. In a context of relations of asymmetry between the State and the churches and the pluralization of the religious field, diverse needs for spiritual aide in state institutional spaces arise. It is in such a framework that this organization of chaplains gains institutional status, developing its own ethos in search of recognition, visibility and social legitimacy to offer chaplaincy services in institutions where the only chaplains recognized and funded by the State belong to the Catholic religion.
En este artículo nos interesa reconstruir cómo se desarrolla el proceso de institucionalización de un presbiterio de capellanes no católicos para poder adaptarse e interactuar con las instituciones públicas de Argentina, particularmente, las de salud. Para ello, se realizaron entrevistas cualitativas a actores religiosos formados en temas de bioética, observación participante en espacios de formación, congresos y jornadas de bioética y salud y análisis documental de material de estudio y declaraciones de actores religiosos sobre temas de salud y bioética. En un contexto de relaciones de asimetría entre el Estado y las iglesias y pluralización del campo religioso surgen requerimientos de asistencia espiritual diversos en espacios institucionales estatales. En este marco se institucionaliza esta organización de capellanes que desarrolla un ethos propio en búsqueda de reconocimiento, visibilidad y legitimidad social para ofrecer un servicio de capellanía en instituciones donde los únicos capellanes reconocidos y solventados por el Estado pertenecen a la religión católica.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Hospitales Públicos , Religión , Terapias Espirituales , Argentina , Catolicismo , HumanosRESUMEN
RESUMEN En este artículo nos interesa reconstruir cómo se desarrolla el proceso de institucionalización de un presbiterio de capellanes no católicos para poder adaptarse e interactuar con las instituciones públicas de Argentina, particularmente, las de salud. Para ello, se realizaron entrevistas cualitativas a actores religiosos formados en temas de bioética, observación participante en espacios de formación, congresos y jornadas de bioética y salud y análisis documental de material de estudio y declaraciones de actores religiosos sobre temas de salud y bioética. En un contexto de relaciones de asimetría entre el Estado y las iglesias y pluralización del campo religioso surgen requerimientos de asistencia espiritual diversos en espacios institucionales estatales. En este marco se institucionaliza esta organización de capellanes que desarrolla un ethos propio en búsqueda de reconocimiento, visibilidad y legitimidad social para ofrecer un servicio de capellanía en instituciones donde los únicos capellanes reconocidos y solventados por el Estado pertenecen a la religión católica.
ABSTRACT This article seeks to reconstruct how the process of institutionalization of a presbytery of non-Catholic chaplains developed as a way to adapt and interact with public institutions in Argentina, particularly health care institutions. For this purpose, qualitative interviews with religious actors trained in bioethics were carried out, in addition to participant observation in training spaces and conferences on health and bioethics and documentary analysis of training material and declarations of religious actors on issues of health and bioethics. In a context of relations of asymmetry between the State and the churches and the pluralization of the religious field, diverse needs for spiritual aide in state institutional spaces arise. It is in such a framework that this organization of chaplains gains institutional status, developing its own ethos in search of recognition, visibility and social legitimacy to offer chaplaincy services in institutions where the only chaplains recognized and funded by the State belong to the Catholic religion.
Asunto(s)
Humanos , Religión , Servicio de Capellanía en Hospital/organización & administración , Terapias Espirituales , Hospitales Públicos , Argentina , CatolicismoRESUMEN
BACKGROUND: Little is known about the effect of chaplains on critical care nurses who are caring for critically ill patients and their families. OBJECTIVE: To understand nurses' experiences when they make a referral to the Spiritual Care Department for a patient or the family of a patient who is dying or deceased. Specific aims were to explore spiritual care's effect on nurses and how nurses understand the role of spiritual care in practice. METHODS: A qualitative descriptive study using in-person, semistructured interviews in a 21-bed medical-surgical intensive care unit in a teaching hospital. Purposeful sampling identified nurses who had at least 5 years of experience and had cared for at least 5 patients who died on their shift and at least 5 patients for whom they initiated a spiritual care referral. Interviews were digitally recorded and anonymized; conventional content analysis was used to analyze transcripts. Three investigators independently coded 5 transcripts and developed the preliminary coding list. As analysis proceeded, investigators organized codes into categories and themes. RESULTS: A total of 25 nurses were interviewed. The central theme that emerged was presence, described through 3 main categories: the value of having chaplains present in the intensive care unit and their role, nurses' experiences working with chaplains, and nurses' experiences providing spiritual care. CONCLUSION: Nurses considered spiritual care essential to holistic care and valued the support chaplains provide to patients, families, and staff in today's spiritually diverse society.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Unidades de Cuidados Intensivos , Personal de Enfermería en Hospital/psicología , Espiritualidad , Adulto , Actitud del Personal de Salud , Enfermería de Cuidados Críticos , Femenino , Hospitales de Enseñanza , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Relaciones Enfermero-Paciente , Investigación CualitativaRESUMEN
Spirituality is becoming of increasing importance in the international healthcare context. While patients' spirituality or faith is often overlooked, there is a growing awareness that understanding, addressing and supporting patients' spiritual and faith needs can influence healthcare outcomes. This review aims to illuminate this role and highlight healthcare chaplains' potential in relation to the provision of pastoral support for families during and after patient resuscitation, and the dearth of interdisciplinary education in this field. A rapid structured review was undertaken using four databases-PubMed, CINAHL, PsycINFO and ATLA. Primary research studies published during the 10-year period 2007-2017 written in English addressing the chaplain's role or perceived role in resuscitation were included. An initial search using key terms yielded 18 relevant citations. This reduced to 11 once duplicates were removed. Ultimately five relevant primary research studies were included in the final analysis. This review found few studies that directly explored the topic. Certainly many view the chaplain as a key member of the resuscitation team, although this role has not been fully explored. Chaplains likely have a key role in supporting families during decisions about 'not for resuscitation' and in supporting families during and after resuscitation procedures. Chaplains are key personnel, already employed in many healthcare organisations, who are in a pivotal position to contribute to future developments of spiritual and pastoral care provision and support. Their role at the end of life, despite well described and supported, has received little empirical support. There is an emerging role for chaplains in healthcare ethics, supporting end-of-life decisions and supporting family witnessed resuscitation where relevant. Their role needs to be more clearly understood by medical staff, and chaplain's input into undergraduate medical education programmes is becoming vital.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Clero , Cuidado Pastoral/métodos , Resucitación , Espiritualidad , Adulto , Atención a la Salud , Humanos , Resucitación/ética , Resucitación/psicologíaRESUMEN
Spiritual care is associated with improved health outcomes and higher patient satisfaction. However, chaplains often cover many hospital units and thus may not be able to serve all patients. Involving student chaplains in patient spiritual care may allow for more patients to experience the support of spiritual care. In this study, we surveyed 93 patients hospitalized on general medical units at a tertiary care center who were visited by nine student chaplain summer interns. The results indicated that the majority of patients appreciated student chaplain visits and these encounters may have positively influenced their overall hospital experience. Thus, student chaplains could be a way to extend valuable spiritual care in settings where chaplaincy staff shortages preclude access.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Servicio de Capellanía en Hospital/estadística & datos numéricos , Clero , Cuidado Pastoral , Satisfacción del Paciente/estadística & datos numéricos , Espiritualidad , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Hospitalización , Humanos , Masculino , EstudiantesRESUMEN
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.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Salud Holística , Cuidado Pastoral/normas , Espiritualidad , Estonia , Humanos , Encuestas y CuestionariosRESUMEN
This article examines the educational issues in ongoing professional education for spiritual care practitioners. A meta-evaluation of registration and evaluation data over four years (between 2013 and 2016) of one such monthly program conducted by Spiritual Health Victoria (Australia) will be examined. Recommendations are made to support healthcare managers and spiritual care educators in designing and developing continuing education programs for spiritual care practitioners in a variety of other professional health and care contexts.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Educación Continua/organización & administración , Cuidado Pastoral/educación , Práctica Profesional/organización & administración , Religión y Medicina , Curriculum , Humanos , Teología/educación , VictoriaRESUMEN
The role of the pastoral practitioner is embedded in many health care services and organizations. Despite this, there is little evidence to describe the impact of this role on patient outcomes, in particular how visits by a pastoral practitioner influence patient healing and recovery. This paper describes a small study that explored the patient experience of pastoral practitioner visits in an acute care facility.
Asunto(s)
Enfermedad Aguda/psicología , Servicio de Capellanía en Hospital/organización & administración , Cuidado Pastoral/métodos , Religión y Medicina , Espiritualidad , Consejo/métodos , Humanos , Relaciones Profesional-PacienteRESUMEN
Stereotypes of religious professionals can create barriers for those who provide spiritual/pastoral care. Through interviews and journal entries, hospice chaplains ( n = 45) identified the following stereotypes that affected their work: chaplains as people whom others try to impress, who only talk about spiritual and religious topics, who are male, and who try to convert others. Participants reported using a variety of communication strategies to counteract stereotypes and make meaningful connections with the people they serve.
Asunto(s)
Servicio de Capellanía en Hospital/organización & administración , Clero/psicología , Cuidado Pastoral/métodos , Relaciones Profesional-Familia , Cristianismo/psicología , Cuidados Paliativos al Final de la Vida/organización & administración , Humanos , Masculino , Cuidado Pastoral/organización & administraciónRESUMEN
This study advances the work of developing a theory for educating Clinical Pastoral Education (CPE) Supervisors by describing the behaviors which result from the successful completion of CPE supervisory education. Twenty-eight Association for Clinical Pastoral Education (ACPE) Certification Commissioners were interviewed to identify the behaviors demonstrated by Supervisory Education Students (Candidates) which influenced the decision to certify them at the level of Associate Supervisor. Specific behavioral descriptors are listed for each ACPE supervisory competency.