How's Your Soul?

In this narrative essay, a physician reflects on the way in which his residency program director's unique background as a Master of Divinity helped him to focus on his growth as a human being rather than concentrating solely on clinical evaluations.

The University Chaplain: An Often Unrecognised Resource in Suicide Prevention-Initial Qualitative Results from Exploratory Research into the Roles of University Chaplains at One Australian University.

University chaplains are often unrecognised as resources in suicide prevention. This exploratory article highlights the valuable contributions university chaplains at one Australian university make to suicide prevention. Three overarching themes related to the contributions of university chaplains to suicide prevention were generated: (1) person-centred care; (2) the role of university chaplains in suicide prevention; and (3) professional development. Of particular note is that university chaplains actively contribute to all three phases of the suicide prevention framework: prevention, intervention, and postvention.

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.

Exploring Religion as a Path to Meaning: The Role of "Pastrotherapy" in Supporting Young People's Quest for a Good Life in Nigeria.

This paper examines suicide prevalence among Nigerian youth struggling to find meaning in life. Frustrated by unattainable ideals, they experience despair. The study explores religion's role in providing support for meaning-seeking individuals. Utilizing an explorative approach, the paper highlights how religion can play a role in offering solidarity, morality, and hope as vital resources for creating a meaningful life. It introduces "Pastrotherapy" as a pastoral care approach to addressing existential questions. Findings emphasize the importance of religious communities and leaders in promoting resilience and addressing underlying causes of despair. This study reveals how religious beliefs and practices support Nigerian youth facing existential challenges, shedding light on the intersection of religion, meaning-making, and mental health.

Healthcare chaplains' conflicting and ambivalent positions regarding meaning in life and worldview.

Western society is increasingly a spiritual society, but not so much a society that draws on clearly delineated religious or worldview pillars anymore. Within healthcare, there's a growing attention to the spiritual dimension of health and the collaborative spiritual care that is needed for person-centered care. This changing religious/worldview and healthcare landscape is influencing healthcare chaplaincy. In this case study in-depth interviews were conducted with a chaplaincy team within a large healthcare organization in The Netherlands. Dialogical Self Theory was used as the theoretical framework in the narrative analysis of these stories. This provided insights into how these chaplains negotiate their professional identity within a changing healthcare landscape. It is concluded that there are multiple and often contradictory and conflicting positions within and between chaplains and that it is a challenge for healthcare chaplains to integrate the "old" and "new" representations of chaplaincy.

Pastoral Narrative Disclosure: The Development and Evaluation of an Australian Chaplaincy Intervention Strategy for Addressing Moral Injury.

This paper describes the development and initial chaplaincy user evaluation of 'Pastoral Narrative Disclosure' (PND) as a rehabilitation strategy developed for chaplains to address moral injury among veterans. PND is an empirically informed and integrated intervention comprising eight stages of pastoral counselling, guidance and education that was developed by combining two previously existing therapeutic techniques, namely Litz et al's (2017) 'Adaptive Disclosure' and 'Confessional Practice' (Joob & Kettunen, 2013). The development and results of PND can be categorized into five phases. Phase 1: PND Strategy Formation-based upon extensive international research demonstrating that MI is a complex bio-psycho-social-spiritual syndrome with symptoms sufficiently distinct from post-traumatic stress disorder. The review also provided evidence of the importance of chaplains being involved in moral injury rehabilitation. Phase II: Development and Implementation of 'Moral Injury Skills Training' (MIST)-which involved the majority of available Australian Defence Force (ADF) Chaplains (n = 242/255: 94.9%) completing a basic 'Introduction to Moral Injury' (MIST-1) as well as an 'Introduction to PND' (MIST-2). Phase III: MIST-3-PND-Pilot evaluation-involved a representative chaplaincy cohort (n = 13) undergoing the PND eight-stage strategy to ensure the integrity and quality of PND from a chaplaincy perspective prior to wider implementation. The pilot PND evaluation indicated a favourable satisfaction rating (n = 11/13: 84.6%; M = 4.73/5.0 satisfaction). Phase IV: MIST-3-PND Implementation-involved a larger cohort of ADF Chaplaincy participants (n = 210) completing a revised and finalized PND strategy which was regarded favourably by the majority of ADF Chaplains (n = 201/210: 95.7%; M = 4.73/5.0 satisfaction). Phase V: Summation. In conclusion the positive satisfaction ratings by a significant number of ADF chaplaincy personnel completing MIST-3-PND, provided evidence that chaplains evaluated PND as a suitable counselling, guidance and education strategy, which affirmed its utilisation and justifies further research for using PND to address MI among veterans, that may also prove valuable for other chaplains working in community health and first responder contexts.

Spiritual Caregiving and Assessments for America's Religious 'Nones': A Chaplaincy Perspective.

One in four American patients now identify as religiously unaffiliated. This study utilizes thematic analysis to deliver qualitative results from in-depth interviews conducted with five chaplains at a premier cancer research institution in Florida to envision what care for their spiritual dimension should look like in practice. It demonstrates why the chaplains interviewed suggested that spiritual caregiving still contributes to their holistic wellbeing, and it suggests how spiritual care and assessments may be provided to so-called religious 'nones'-or those who identify as spiritual but not religious, not religiously affiliated, secular humanist, atheist, agnostic, and so on. We conclude with a novel spirituality assessment for use while serving this patient population.

Patient Religiosity and Desire for Chaplain Services in an Outpatient Primary Care Clinic.

Outpatient chaplaincy is a new specialty in healthcare, with a relative paucity of research studies exploring the need for spiritual care interventions in ambulatory settings. Over the past 3 years, our interdisciplinary team at the Duke Outpatient Clinic has piloted the extension of professional spiritual care into this hospital-based resident teaching clinic offering primary care to underserved populations in Durham, NC. In this article, we report the results of a series of surveys that we conducted at the clinic to assess patients' perceptions of chaplain services, understanding of Chaplains' roles, and desire for chaplain services in specific hypothetical scenarios. As part of this survey, we also asked patients about their personal levels of extrinsic and intrinsic religiosity using the well-validated Duke University Religion Index. Our results indicate which chaplain interventions are most desired among this patient population in relation to patients' self-reported religiosity. We hypothesized that only our more religious patients would strongly desire chaplain support for the majority of scenarios presented. We were surprised to find that a majority of our patients-regardless of their own level of religiosity-express desire for support from an outpatient healthcare chaplain when they need a listening ear, are grieving a loss, or are seeking prayer.

Challenges in pastoral care practice in euthanasia: A concept mapping study among Dutch protestant pastors.

This study explores the various difficulties that protestant pastors experience in the context of care for parishioners with a wish for euthanasia. In a reproducible and non-subjective way, using the concept mapping method, we cluster and rank-order 600 elements that pastors had mentioned as "difficult in caring for parishioners with a death wish" in an earlier survey study. The three clusters of items ranked as most difficult are connected with inappropriate care, doubts whether euthanasia in specific circumstances is justified, and disagreements between pastor and parishioner, including the emotional burden arising from those disagreements.

Ethical Conflicts in Healthcare Chaplaincy: Results of an Exploratory Survey Among Protestant Chaplains in Switzerland, Germany, and Austria.

The paper reports the results of an exploratory online survey among German, Austrian, and Swiss hospital chaplains (n = 158, response rate 17%) to identify the ethical conflicts they encounter in their work. Respondents indicated that questions surrounding end-of-life care are predominant among the conflicts faced. Chaplains get involved with these conflicts most often through the patients themselves or through nursing staff. Most encounters occur during pastoral care visits rather than in structured forms of ethics consultation such as clinical ethics committees. The results add to the ongoing discussion of chaplains as agents in ethics consultation within healthcare systems as well as their specific role and contribution.

Role-Related Stress and Adversity Impacting Christian Clergy Resilience: A Pan-Canadian Study.

Christian clergy are at risk of experiencing the negative impacts of role-related stress and adversity, especially burnout. The findings reported in this article were derived from a Canadian mix-methods study that collected data through an online survey with 519 clerics, 13 one-on-one interviews, and interpretation panels. Adversity themes identified related to workload, expectations, isolation, and personal challenges with various subthemes for each. These findings are relevant to those providing care to clergy by providing insights into the challenges they face.

American health care chaplains' narrative experiences serving during the COVID-19 pandemic: a phenomenological hermeneutical study.

The COVID-19 pandemic significantly impacted North American health care chaplains' modes of work and emotions. To capture the experiences of health care chaplains across the United States, 30 Board Certified (or eligible) chaplains were asked to keep a weekly narrative journal of their experiences and emotions during the pandemic from April of 2020 through June of 2020. Twenty-one chaplains submitted their journals for qualitative analysis, amounting to over 90,000 words of chaplain reflection containing rich, descriptive, and often personal stories of health care chaplains. Journals were analyzed using hermeneutic phenomenological methodology. The overarching patterns identified included: The World of Chaplaincy, Policies/Procedures/Visitation, Staff Care, Rituals, Chaplain Emotional Responses, Coping, and Racism. A significant finding was the resiliency and creativity of chaplains despite the rapid changes, uncertainty, and fear brought on by the pandemic. The results further suggest that journaling is a feasible and acceptable method in chaplaincy research.

Chaplains Work in Primary Care.

Health is holistic, but health services are often not. Primary care is the first point of contact for patients in the UK, and at least two in every three present with complex bio-psycho-socio-economic issues. In Scotland, the Community Chaplaincy Listening (CCL) service was created to see if chaplains could help. CCL involves specially trained chaplains listening to patients referred to them by general practitioners (GP) for spiritual support. Between 2018 and 2019, 143 people used CCL and completed baseline and post-discharge outcome measures. Mean Scottish PROM scores rose from 7.94 (± 3.4) at baseline to 12 (± 3.5) post discharge, a statistically and clinically significant rise of 4.06 (95% CI, 3-5.12), t(50) = 7.7, p < 0.0001, d = 1.08. The improvement was seen whether patients self-described as religious, spiritual, both, or neither. Health-related quality of life outcomes were mixed but patients referred to the service scored some of the lowest baseline EQ-5D-3L scores ever seen in the literature. Together these results suggest that CCL worked in primary care, especially for patients historically considered "difficult to treat." Limitations of the study are considered alongside implications for commissioners and service developers.

Hospital chaplains facing the pandemic. A qualitative study.

The article explores hospital chaplains perspective on the impact of the coronavirus pandemic on the provision of spiritual care in Poland. Semi-structured interviews with sixteen hospital chaplains providing spiritual care in hospitals during the COVID-19 pandemic were performed. Six main themes emerged during the interviews: chaplains' experience of the pandemic, chaplaincy during the outbreak, patients' needs, health professionals needs, social stigma and discriminatory behaviours against chaplains, and the importance of spiritual care during the crisis. Results indicate that although the COVID-19 crisis has limited the possibilities of providing spiritual care in hospitals and has changed its nature, it has positively impacted the visibility of hospital chaplaincy. It also underpins the contribution of hospital chaplains to modern healthcare practice and suggests that chaplains role as key healthcare workers should be further recognized and their integration into the healthcare system is required.

The professionalization of chaplaincy A Comparison of 1997 and 2017 Surveys in The Netherlands.

Chaplaincy has become increasingly professionalized in response to both the standardization in healthcare and the changing religious landscape. Whereas several studies have paid attention to the professionalization of chaplaincy as a whole, no research has been found that describes the implications for individual chaplains. The present article describes the professionalization of Dutch chaplains in the last two decades. We compared the results of two surveys conducted with chaplains in the Netherlands in 1997 and 2017. We describe professionalization by distinguishing between the changed values, expertise, and positioning of chaplains. We found that chaplains' expertise has been developed by a growing but highly diverse body of knowledge. Furthermore, a pluralization of chaplains' worldviews was observed, including non-religious and non-affiliated positions. Lastly, no major changes were observed in the embedding of chaplains.

The future of chaplaincy in a secularized society: a mixed-methods survey from the Netherlands.

The spiritual care profession in the Netherlands is going through significant changes, including an increasing demand for secular and multi-faith spiritual care, a move towards professionalization and formulating 'best practices', as well as a broadening of the scope of chaplains' activities.In October 2019, 405 Dutch healthcare chaplains completed an online mixed methods survey with open and closed-ended questions about their work situation and professional identity. Quantitative analyses showed that most respondents evaluated current developments in chaplaincy in a positive way. Qualitative findings showed trends towards interconfessional and secular spiritual care, outpatient spiritual care and the emergence of evidence-based chaplaincy. Participants who responded most negatively to those developments criticized evidence-based approaches for measuring the effects of chaplaincy, unstable financing structures, and the encroachment of other professions upon the domain of spiritual care.

Life and Death Sometimes Coincide, and Pastoral Response is Crucial to the Brokenhearted.

Perinatal loss may remain unexplained, despite current technology, modern preventive care measures, and advanced diagnostic procedures. Culturally sensitive and competent discussions should be prioritized in medicine, but religious and spiritual feelings are often marginalized. Here we highlight our reflections on the importance of the spiritual and theological responses to parents grieving stillbirth. Chaplains are critical for the wellbeing of both families and physicians.

Exploring the Perceptions Surrounding Hospital Chaplains in Patient Care and Healing.

The authors distributed a questionnaire to various hospital staff to explore perceptions surrounding the role of chaplains in patient care and healing through assessing opinions, beliefs, and knowledge. Results revealed a poor understanding of the role of the hospital chaplain in the UK. The authors therefore advocate education programs to increase awareness of the varied role of the hospital chaplain in fulfilling patient spiritual needs to increase referral practices, leading to improved patient outcomes.

Australian Chaplaincy Support of Health Care Staff: Presence, Professional and Relational.

The aim of the research was to explore how health care staff experienced support from hospital chaplains. The context for the study was two acute care hospitals in the South Australian Government's public health system: one paediatric, the other adult. The research utilised semi-structured interviews that were transcribed and analysed and coded using established methodologies for qualitative studies. The results and subsequent analysis revealed two overarching themes which emerged from the narratives of staff members. Support from chaplains was perceived as being (i) part of the hospital institution, (ii) a participant in the overall care team, (iii) as a symbolic presence, and (iv) available in the diverse settings of education, crisis and trauma events and debriefings. Chaplaincy support was experienced in relational and spontaneous care in serendipitous meetings with staff or at a workstation which was experienced as inclusive and respectful.

Factors Influencing Military Personnel Utilizing Chaplains: A Literature Scoping Review.

Chaplains have been embedded in military settings for over a millennium. In recent years however, the decline in spiritual/religious (S/R) affiliation of military personnel across Western cultures has led to some commentators questioning the utilization of religious chaplains by defence personnel. This scoping review maps the literature on S/R and non-S/R factors that influence utilizing military chaplains-with a particular emphasis on the Australian military context. A systematic scoping review of tertiary literature databases using Arksey and O'Malley (2003) and Joanna Briggs Institute methodologies (JBI, 2021), revealed a total of 33 articles meeting the inclusion criteria. Results fell into three broad categories: (i) how personal religious views influence utilization of military chaplaincy, (ii) barriers and enablers to personnel utilizing military chaplains, and (iii) the impact of chaplaincy. Despite the current reduction in religiosity in Western society, findings from this scoping review suggest there is little evidence that low religiosity among military personnel forms a significant barrier to utilizing chaplaincy services. To the contrary, the literature revealed that chaplains provide trusted, confidential, and holistic support for military personnel that if diminished or compromised would leave a substantial gap in staff well-being services.