Spiritual care performed in a drug user clinic.

OBJECTIVE: To know the spiritual care practices of health workers in the context of an inpatient unit for the treatment of addictive disorders, aiming to incorporate an expanded care practice. METHOD: Qualitative study considering the Convergent Care Research theoretical framework. The data collection occurred using semi-structured interviews, with three rounds of conversations and informal chats with 14 health professionals, from July to November 2017. The analysis followed the steps of apprehension, synthesis, theorization and transference. RESULTS: Four categories emerged: respect for user ethical values; addressing the beliefs and values of professionals; the health professional-user relationship; and collective spiritual care. The main actions highlighted were individual (relaxation and prayer) and collective (meditation, spirituality and the 12 steps). CONCLUSION: The rounds of conversations carried out in this research allowed workers to talk about spiritual care in addiction, to better understand its relevance to meet the needs of the patient.

Quality Pastoral Relationships in Healthcare Settings: Guidelines for Codes of Ethics.

"Pastoral caregiver-patient relationships" sections in ethical codes commonly provide a list of principles, proscriptions and prescriptions, with a focus on boundaries to safeguard the professional character of pastoral relationships and avert their harmful potential. The article promotes this code section's coherency and comprehensiveness by respectively (i) drawing a framework in the context of which ethical guidance can be orderly presented, and (ii) focusing on the inter-personal core of pastoral relationships and their healing potential.

Spiritual care performed in a drug user clinic / El cuidado espiritual realizado en una unidad de internación en adición / O cuidado espiritual realizado em uma unidade de internação em adição

ABSTRACT Objective: To know the spiritual care practices of health workers in the context of an inpatient unit for the treatment of addictive disorders, aiming to incorporate an expanded care practice. Method: Qualitative study considering the Convergent Care Research theoretical framework. The data collection occurred using semi-structured interviews, with three rounds of conversations and informal chats with 14 health professionals, from July to November 2017. The analysis followed the steps of apprehension, synthesis, theorization and transference. Results: Four categories emerged: respect for user ethical values; addressing the beliefs and values of professionals; the health professional-user relationship; and collective spiritual care. The main actions highlighted were individual (relaxation and prayer) and collective (meditation, spirituality and the 12 steps). Conclusion: The rounds of conversations carried out in this research allowed workers to talk about spiritual care in addiction, to better understand its relevance to meet the needs of the patient.

RESUMEN Objetivo: Conocer las prácticas de cuidado espiritual de los trabajadores de la salud en el contexto de una unidad de hospitalización para el tratamiento de trastornos adictivos, con el objetivo de incorporar una práctica de atención ampliada. Método: Estudio cualitativo con referencial metodológico de la Investigación Convergente Asistencial. Se realizaron entrevistas semiestructuradas, tres rondas de conversaciones y conversaciones informales con 14 trabajadores de salud en una internación por adición de julio a noviembre de 2017. El análisis de las informaciones siguió las etapas de aprehensión, síntesis, teorización y transferencia. Resultados: Surgieron cuatro categorías: respeto de los valores éticos de los usuarios; creencias y valores de la persona; relaciones profesional de salud-usuario; y cuidado espiritual en grupo. Las principales acciones destacadas fueron individuales (relajación y oración) y colectivas (meditación, espiritualidad y 12 pasos). Conclusión: Las rondas de conversaciones, realizadas en esta investigación, permitieron a los trabajadores conversar sobre el cuidado espiritual en la adición, comprendiendo mejor su relevancia asistencial para atender las necesidades del paciente.

RESUMO Objetivo: Conhecer as práticas de cuidado espiritual de trabalhadores de saúde no contexto de uma unidade de internação para o tratamento de transtornos aditivos, visando incorporar uma prática assistencial ampliada. Método: Estudo qualitativo com referencial metodológico da Pesquisa Convergente Assistencial. Foram realizadas entrevistas semiestruturadas, três rodadas de conversas e conversas informais com 14 trabalhadores de saúde em uma unidade de internação em adição de julho a novembro de 2017. A análise das informações seguiu as etapas apreensão, síntese, teorização e transferência. Resultados: Emergiram quatro categorias: evocação dos valores éticos dos trabalhadores; respeito às crenças e valores do usuário; encontro trabalhador de saúde-usuário e cuidado espiritual em grupo. As principais ações destacadas foram individuais (relaxamento e oração) e coletivas (meditação, espiritualidade e 12 passos). Conclusão: As rodadas de conversas, realizadas nesta pesquisa, permitiram aos trabalhadores conversarem sobre o cuidado espiritual na adição, compreendendo melhor a sua relevância assistencial para atender às necessidades do paciente.

In search of good care: the methodology of phenomenological, theory-oriented 'N=N case studies' in empirically grounded ethics of care.

This paper proposes a new perspective on the methodology of qualitative inquiry in (care) ethics, especially the interaction between empirical work and theory development, and introduces standards to evaluate the quality of this inquiry and its findings. The kind of qualitative inquiry the authors are proposing brings to light what participants in practices of care and welfare do and refrain from doing, and what they undergo, in order to offer 'stepping stones', political-ethical insights that originate in the practice studied and enable practitioners to deal with newly emerging moral issues. As the authors' aim is to study real-life complexity of inevitably morally imprinted care processes, their empirical material typically consists of extensive and comprehensive descriptions of exemplary cases. For their research aim the number of cases is not decisive, as long as the rigorous analysis of the cases studied provides innovative theoretical insights into the practice studied. Another quality criterion of what they propose that should be called 'N=N case studies' is the approval the findings receive from the participants in the practice studied.

Suffering for Others While Making Others Suffer: Military Narratives of Sacrifice.

Voices from theology seldom participate in a contemporary conversation on military cultures and identities; this article attempts to stimulate this conversation from such a perspective. The article combines a literature review with narratives of sacrifice from real-life cases. It presents a reflective perspective on the formation of military identities with regard to responsibilities and sacrifices. Forgiveness and atonement are discussed as pathways to cultivate growth which can lessen feelings of guilt and regret.

Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer.

The Need to Be Seen.

When we recognize our common humanity, suspend judgment and embrace the intrinsic value and worth of every individual, we elevate those we serve, and we elevate ourselves. Whether or not we are able to offer cure, we are always capable of fulfilling our mission to heal.

Perspectives of Taiwanese pastoral counselors on the use of scripture and prayer in the counseling process.

Interviews were carried out with 10 Christian pastoral counselors to explore their perspectives on the use of Scripture and prayer in the counseling process. Grounded Theory was utilized. Five main categories including a theological framework of pastoral counseling, counselors' considerations of using Scripture and prayer, preparation for Christian spiritual intervention, implications of spiritual resources, and ethical issues in the pastoral counseling process were generated. The results suggest the theological framework of pastoral counseling is crucial to the use of Scripture and prayer, and the issue of a neutral response should first be clarified for clients. Basic guidelines for ethically using Scripture and prayer for working with Christian clients are proposed for further pastoral counselor training, practice, and research.

Clinically assisted hydration and the Liverpool Care Pathway: Catholic ethics and clinical evidence.

The Liverpool Care Pathway for the Dying Patient (LCP), a framework introduced for providing comfortable care at the last stage of life, has recently become highly contentious. Among the most serious allegations levelled against it, has been that the LCP may be used as a covert form of euthanasia by withdrawal of clinically assisted hydration (CAH). This concern has been raised, in particular by a number of Catholic medical professionals, who have asserted that the LCP is incompatible with Catholic ethics. This paper examines the key Catholic ethical principles relevant to treatment and care towards the end of life (the sanctity/inviolability of life principle, the distinction between ordinary and extraordinary means). Relevant current clinical evidence regarding CAH in relation to terminal thirst, dehydration, prolongation of life and possible negative impacts on the dying is also scrutinised. It is argued that for some patients at the very end of life it may be permissible and even desirable to withhold or withdraw it. Thus, as administration of CAH may become extraordinary, forgoing it in some situations is fully compatible with Catholic ethics. The article therefore concludes that the stance of the LCP in respect of provision of CAH is fully in alignment with Catholic teaching.

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.

A psychospiritual, family-centered theory of care for mothers in the NICU.

Weighing less than three pounds four ounces, very low birthweight infants account for 1.4% of births and 46% of infant deaths in the U.S. Mothers of these infants often endure significant suffering while witnessing their children struggle for life. By examining their psychological and theological needs, and drawing on a mother's lived experience, this article develops a psychospiritual, family-centered theory of care to aid chaplains in providing spiritual care to mothers in the NICU.

Pastoral identity constructed in care-giving relationships.

From developmental and training perspectives, previous studies have defined pastoral identity as an individual property of pastoral practitioners. Grounded on an empirical study of interviewing 20 pastoral counselors and chaplains, this paper presents pastoral identity as a social construction between pastoral caregivers and seekers (and God in the midst). Informed by a recent social-psychological approach to identity, the paper explores one possibility for an interactional, intersubjective, and constructive paradigm of pastoral identity.