A survey regarding the role of UK dietitians in spiritual care.

BACKGROUND: Users of dietetic services have unmet spiritual needs, although no study has yet explored dietitians' opinion, perceptions or experience of assessing spiritual needs and delivering spiritual care in clinical practice. METHODS: A cross-sectional survey assessed the role of UK dietitians in spiritual care. RESULTS: Thirty-seven practicing dietitians, with experience ranging from newly qualified to over 21 years of practice, took part in the survey containing open and closed questions. Almost half (49%) of dietitians said they always conducted spiritual assessments and most (57%) said they sometimes made a referral for spiritual concerns. When spiritual issues arose, dietitians were highly likely to listen well (score 4.6 out of 5) and encourage service users in their own (the service user) spiritual or religious practices (score 4 out of 5). However, the likelihood of taking the initiative and enquiring about religious and spiritual issues was lower (score <3 out of 5) in all areas of practice including end of life care. This may have been because confidence around spiritual care was also low (score 4.7 out of 10), uncertainty was high (score >3.5 out of 5) and there was a strong desire to receive training (>4 out of 5). Qualitative responses expanded further on these results suggesting that there was positive "intention" to provide spiritual care, but lack of training was a significant barrier (qualitative theme: "inadequacies"). The recognition of necessity but uncertainty of how to meet spiritual needs was also shown through qualitative findings to be a source of "emotional labour", particularly where there were conflicting beliefs between a dietitian and service user. CONCLUSIONS: Although limited by a small sample size, these results provide new knowledge that spiritual care is considered an important part of the dietitians' role and that this is the case regardless of the dietitians own spiritual identity or religion. Dietitians would value training in spiritual care so that they can support service user needs more readily and confidently.

Expert testimony in capital sentencing: juror responses.

The U.S. Supreme Court, in Furman v. Georgia (1972), held that the death penalty is constitutional only when applied on an individualized basis. The resultant changes in the laws in death penalty states fostered the involvement of psychiatric and psychologic expert witnesses at the sentencing phase of the trial, to testify on two major issues: (1) the mitigating factor of a defendant's abnormal mental state and (2) the aggravating factor of a defendant's potential for future violence. This study was an exploration of the responses of capital jurors to psychiatric/psychologic expert testimony during capital sentencing. The Capital Jury Project is a multi-state research effort designed to improve the understanding of the dynamics of juror decision-making in capital cases. South Carolina data (n = 214) were used to investigate the impact of expert testimony on the mitigating factor of mental illness and the aggravating factor of future dangerousness. Ordered logit regression analyses revealed significant correlations (p < .005) between the presence of a defense psychiatrist or psychologist expert witness during the sentencing phase and jurors' having the impression that the defendant was mentally disturbed. Similar analyses revealed no significant relationship between the presence of state-introduced psychiatric testimony and jurors' having the impression that the defendant, if not executed, would be violent in the future. These findings seem to contradict the view that psychiatric testimony on future dangerousness in death penalty cases has a powerful impact on jurors. The jurors in this study were significantly influenced, however, by psychiatric/psychologic testimony in the area of a defendant's mitigating mental abnormality.