Healthcare Chaplaincy for Geriatric Patients: A Quasi-Experimental Study into the Outcomes of Catholic Chaplaincy Interventions in Belgium.

The present non-randomized clinical trial examined the short-term outcomes of one-on-one chaplaincy interventions with 416 geriatric patients in Belgium. Participants were interviewed one or two days before a potential chaplaincy intervention (baseline measurement), and one or two days after a potential intervention (post-measurement). Patients in the non-randomized intervention group received an intervention by the chaplain, while the non-randomized comparison group did not. Patients in the intervention group showed a significant decrease in state anxiety and negative affect, and a significant improvement in levels of hope, positive affect, peace, and Scottish PROM-scores, compared to the comparison group. Levels of meaning in life and faith did not significantly change after the chaplaincy intervention. This study suggests that geriatric patients may benefit from chaplaincy care and recommends the integration of chaplaincy care into the care for older adults.

Reflections for Clinical Pastoral Education Students in Psychiatric Settings.

This article focuses on Donald Capps's books on mental illness. In doing so I highlight three key insights from Capps that I have applied in my own ministry with persons with mental illness in various psychiatric hospitals. These insights, together with my own experience as a chaplain, lead to three practical lessons for clinical pastoral education students in psychiatric settings. I provide some context for my interest in mental illness and my friendship with Capps, as well as some background regarding how Capps's writings on mental illness fit with certain broader themes in his own work as a pastoral theologian. This essay is personal throughout.

Spiritist Hospital Chaplaincy in Brazil: 5 Years of Documented Experience.

Spiritist Hospital Chaplaincy in Brazil has been growing significantly in recent years, with the implementation of new services through the work of Spiritist Medical Associations (SMAs) in different regions of the country. This article describes the importance of historical interconnections from the advent of spiritism in the world and its introduction in Brazil to the emergence of Spiritist Hospital Chaplaincy in our country and presents the documented experience over 5 years of spiritist chaplain care, in the period from 2012 to 2016, guided by the SMA of Piracicaba at the Unimed Hospital of Piracicaba (São Paulo). We documented 41,914 visits to 13,983 inpatients and an analysis of these records allowed us to reflect on the importance of this service and confirm its expansion and acceptance by different contemporary religious beliefs.

Integrating Spiritual Care into Palliative Consultation: A Case Study in Expanded Practice.

Recognizing and addressing spiritual needs has long been identified as a key component of palliative care (PC). More often than not, the provision of spiritual care involves referral to a hospital chaplain. In this study, we aim to describe the role of a PC chaplain embedded within the interdisciplinary PC team and demonstrate how this palliative chaplain role differs from that of a traditional hospital chaplain. We postulate that integrating spiritual care provision into a PC team may offer a broader spiritual care experience for patients receiving PC and begin to delineate expanded clinical roles for the palliative chaplain.

Perceptions of Chaplains' Value and Impact Within Hospital Care Teams.

Many scholars have written about the role of spirituality in health care. One mechanism for incorporating spirituality into the care of patients is to integrate clinically trained chaplains into hospital care teams. We examined in a mixed-methods fashion, the effects of this type of integrated care team within a teaching hospital setting. The quality and impact of chaplain involvement were studied from patient and physician-in-training perspectives, using data from more than 200 patients and physicians in training. Findings clearly show that clinically trained chaplains can contribute meaningful expertise and real value to the quality and comprehensiveness of patient and physician experiences.

'Paramedical' Healing in Hospitals: The Expansion of Spiritual Care in Seoul.

Emotional and spiritual healing stand at the center of the activity of Catholic pastoral caregivers attending to the sick in non-Catholic hospitals in Seoul. In this paper I explore how these agents understand their practice as part of a holistic human healing, positioning their work side by side with medical healing. I also examine how their role is both confirmed and challenged against the backdrop of the growing commercialization of the health care industry under the neoliberal paradigm.

The Spiral Staircase: A Narrative Approach to Pastoral Conversation.

The following is a patient-centered pastoral conversation paradigm to be used by chaplains, pastors, or any other spiritual care provider, in engaging in healing conversation with patients, clients, or parishioners. It is based on the intimate, interpathic incarnation of oneself into another's story.

Spiritual Care and CPE: 2nd Year Experience.

The aim of this article is to provide the experience of one chaplain resident in a clinical pastoral education program specializing in women and infants health and the intersection of professional spiritual care for this particular patient population. Spiritual care can be an elusive, non-tangible form of professional healthcare, and so within the clinical setting the chaplain is called to act as spiritual care provider, emotions facilitator, grief counselor, cultural and religious expert and administrative specialist in decedent care. Gaining a better perspective on the contributions the clinical chaplain makes in healthcare allows other clinicians (nurses and physicians) to better serve and provide quality holistic care to patients and their families during moments of great emotional, spiritual and psychosocial loss and grief. Both nursing and physician staff must be aware of the relevance, importance and complementary role of the spiritual care provider (clinical chaplain) in the provision of quality holistic healthcare.

Art at the Bedside: Reflections on Use of Visual Imagery in Hospital Chaplaincy.

'Art at the Bedside' is the name given to a hospital visitation program during which works of art loaded onto a computer are used to start conversations with patients and their families. The article traces the genesis of the program that evolved from the author's dual training in art museum education and hospital chaplaincy through the evolution of the practice, now in its sixth year. Reflections on the practice itself are the focus of this article, from identifying the kinds of responses frequently elicited by the artwork to understanding how these works of art seem to forge immediate connections between the patient and the facilitator. Ultimately posed in this reflection is whether the 'Art at the Bedside' experience might suggest a future for the integration of the visual arts more broadly into hospital - and related - chaplaincy.

The Haircut.

The article describes my experience - and the lessons learned - with a terminally ill patient in 1977 as a clinical pastoral education chaplain intern.

No Child Left in the Morgue: Standing in as Hope's Family.

This personal reflection expresses a chaplaincy department's feelings as they became the surrogate family for a child whose body was abandoned by its mother in the hospital morgue.

Experience of the Spiritist Hospital Chaplaincy Service: A Retrospective Study.

The Hospital Chaplaincy service is made of religious volunteer work done by representatives of various religions properly trained to offer spiritual support to hospitalized patients, as well as their families, contributing as a source of protection, comfort and restoring faith in the face of illness. The objective of this study is to present a retrospective analysis of records made by chaplains, guided by the Spiritist Medical Association of Piracicaba, through 7419 calls to 2191 patients admitted at Unimed Hospital of Piracicaba in 2014. The results contributed to the production of scientific documentation about this new holistic model that still lies in acceptance phase in the country.

An Integrative Professional Theory and Practice Paper: Personal Reflections from the Journey through Clinical Pastoral Education.

CPE is an experience-based approach to learning spiritual care which combines clinical care with qualified supervision, in-class education and group reflection (CASC--http://www.spiritualcare.ca/). Through didactic seminars, group presentations and personal reading there is opportunity for the student to acquire, apply and integrate relevant theoretical information into their practice. Written for my CPE Specialist application, this paper describes how, through the course of advanced CPE education, I learn to utilize and integrate theory into my clinical work. Beginning with three strands--authenticity, listening and storytelling--I then discuss how the behavioural sciences and theology inform my practice. Focusing on empathy, I speak of the application of disclosure, the use of counter-transference as a diagnostic tool, and the place of therapeutic termination. Group theory, family systems theory, theological reflection, liturgical ministry, and multi-faith practices are considered.

The Effects of CPE on Primary Relationships--Is It Worth Exploring?

Clinical Pastoral Education (CPE) can be a life transforming experience for students, but does it also transform students' primary relationships? An online survey of past CPE students at Royal Perth Hospital, Western Australia, found that--overall--CPE had a positive effect on primary relations in key areas, in particular communication, intimacy and spirituality. Recent relationships were more negatively affected. Some relationships did not survive CPE. Structural and pedagogical implications require further research.

Voices from the Margins: Reflections of an Oncology Chaplain.

Michael Eselun, BCC, who serves as the oncology chaplain for the Simms-Mann/UCLA Center for Integrative Oncology, recently gave a lecture as part of the Insights Into Cancer lecture series at UCLA called 'Cancer: "It Could Be Worse" - A Spiritual Ponzi Scheme?'. Michael has written a personal reflection to provide a fuller context for his chaplaincy, as he views it, and to provide some background to the lecture. A link to a video of the lecture is included.

Recognition and the Fleeting Glimpse of Intimacy: Tracing the Chaplain's Response to Ungrieved Death.

The article traces the response of the hospital chaplain witnessing ungrieved death. Linking grief with cultural recognition, the article analyzes the absence of grief on the occasion of death within outcast social spheres. It then outlines the ways chaplains both participate in the cultural norms that render lives ungrievable and, conversely, in the solidarity of God, who cares for every life and death. The article closes by situating the chaplain as a liminal figure and proposing liminality itself as an opportunity for solidarity.

The Spiritual and Theological Issues Raised by Stillbirth for Healthcare Chaplains.

The death of a baby is one of the most challenging bereavements for parents and healthcare professionals. This study explores the spiritual and theological issues raised for healthcare chaplains as they minister with parents following perinatal bereavement. Chaplains from 85% of maternity units in the Republic of Ireland participated in this study. Suffering, doubt and presence were the main theological themes raised for chaplains following perinatal death. The process of theological reflection is recommended as a sustaining and necessary tool in perinatal healthcare ministry.

Drawing Close to the Brokenhearted: Pastoral Responses to Parents Grieving Stillbirth.

Despite its prevalence worldwide, stillbirth is poorly understood and rarely discussed. Accordingly, ministers and other pastoral caregivers are seldom prepared to counsel and console parents suffering from this type of infant loss and to effectively design, propose, and lead ministries within their faith communities for this grieving population. This article addresses the immediate pastoral needs of bereaved parents and proposes first and second order responses that ministers and faith communities can employ to compassionately and effectively care for parents suffering from the trauma of stillbirth.

Spiritual quality of life in advanced cancer patients receiving radiation therapy.

OBJECTIVE: The aim of this randomized controlled trial for patients with advanced cancer receiving radiation therapy was to determine the effect of a multidisciplinary intervention on spiritual quality of life (QOL) at the end of the intervention (week 4) and at two follow-up time points (weeks 26 and 52). METHODS: One hundred thirty-one persons were randomized to either the intervention or control (forms only) groups. The intervention included six 90-min in-person sessions based on the physical, emotion, social, and spiritual domains of QOL. Three sessions included the spiritual component. Caregivers were present for four sessions, one which included a spiritual component. Ten follow-up phone calls were made to the patients in the intervention group during the 6-month follow-up period. Patients completed the Functional Assessment of Cancer Therapy: General Scale, the Linear Analog Self-Assessment which includes an assessment of spiritual QOL, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) at enrollment, and weeks 4, 27, and 52. RESULTS: Following the intervention, the intervention group demonstrated improved spiritual QOL on the FACIT-Sp, whereas the spiritual QOL of the control group decreased, resulting in significant mean changes between groups (total score: 1.7 vs. -2.9; p < 0.01; meaning/peace subscale: 1.0 vs. -3.5; p < 0.01; faith subscale: 3.1 vs. -1.7; p = 0.04). CONCLUSIONS: The results indicate that a multidisciplinary intervention which includes a spiritual component can maintain the spiritual QOL of patients with advanced cancer during radiation therapy.

Translating spiritual care in the chaplain profession.

Chaplains provide a much-needed service to patients and families requiring spiritual care in the healthcare setting. Despite evidence documenting improvements quality of life for patients using spiritual services, chaplains experience challenges in translating the benefits they provide into concepts understood by patients, team members, and administrators. A qualitative study using interviews with 19 chaplains found that translation problems occur in three main areas: (a) justifying the role to patients and families, (b) determinations of what constitutes a "productive" employee, and (c) effective collaboration with other members of the health care team. This study outlines several strategies used by chaplains to ease the process of translation, as well as some directions for future research.