How Do Healthcare Executives Understand and Make Decisions about Spiritual Care Provision?

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.

Out Of The Ashes: The Alberta Consortium For Supervised Pastoral Education Program.

In Alberta, Canada, supervised pastoral education has grown and thrived for over 50 years. In 2008, due to healthcare funding changes, it was nearly eliminated. This article describes regenerative processes by which former structures have transformed into a new configuration for supervised pastoral education program delivery, including innovative roles for spiritual care preceptors and theological colleges. Out of the ashes, a phoenix is rising. It is called the Alberta Consortium for Supervised Pastoral Education program.

Assisting Faith-Based Organizations Increase Sense of Belonging during the Covid-19 Pandemic.

The Covid-19 pandemic has negatively affected the three basic needs of individuals. Faith-based organization leaders are carrying the additional weight of stewardship of members during these challenging times. Many Faith-based organization leaders feel a sense of responsibility to create environments where members feel a sense of belonging. Five considerations for Faith-based organization leaders hoping to increase belonging are discussed below. Specifically, low-cost options are presented that could be implemented in small-to-large Faith-based organizations.

Nurses and Churches Are Essential to Postdisaster Recovery.

Two nurses, a mother and daughter, each participated in disaster relief efforts after Hurricane Andrew in 1992 and Hurricane Dorian in 2019. In recounting their experiences, both nurses demonstrate the vital contributions nurses can make at the sites of disasters. The invaluable role of churches in contributing to the disaster recovery effort is also described.

A New Perspective on Spiritual Care: Collaborative Chaplaincy and Nursing Practice.

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.

Asiasiga i A'oga ma Nu'u: a child and adolescent post-tsunami intervention based on Indigenous Samoan values.

OBJECTIVE: To describe a community-based single-session group intervention designed to address psychosocial needs of Samoan young people following a tsunami. METHOD: This programme resulted from collaboration between Samoan therapists, Samoan Catholic pastoral care workers and non-Samoan mental health clinicians. Informed by Samoan concepts of self and wellbeing, it incorporated cultural and spiritual practices familiar to Samoan young people and their families as well as body-centred therapeutic techniques, the 'Tree of life' exercise and provision of a cooked meal. RESULTS: Following household visits to affected families in villages throughout southern and eastern Upolu and the island of Manono, the programme was devised and carried out in 11 villages with 1295 children participating. There was a high degree of acceptance of the programme by Pulenu'u (village governance leaders), young people, their families and community members. CONCLUSIONS: Interventions to address the psychological needs of Indigenous Pacific children and adolescents following a major disaster need to be embedded in the values of their communities. This paper describes an innovative programme based on Samoan values that was consistent with evidence-informed principles used to guide post-disaster responses.

Asiasiga: a Samoan intervention to address the immediate mental health needs of Samoan communities after a tsunami.

OBJECTIVE: To describe an Indigenous Samoan psychosocial intervention developed to address the mental health needs of affected communities in Samoa following a tsunami. METHOD: A partnership was established between Samoan therapists, Samoan Catholic pastoral workers and non-Samoan mental health clinicians, informed by Samoan concepts of self and wellbeing. The format developed for visits to significantly affected households was based on a Samoan cultural practice known as asiasiga and was carried out by pastoral workers, with daily group supervision and access to mental health professionals. RESULTS: Household visits were offered to affected families in villages throughout southern and eastern Upolu and the island of Manono. There was a high degree of acceptance of the programme by Pulenu'u (village governance leaders) and family leaders and members. CONCLUSIONS: Mental health responses to the needs of Indigenous Pacific communities following a disaster need to be embedded in the values of those communities. The Samoan practice of asiasiga contributed to the high degree of acceptability of this programme. Partnerships with churches, schools and other local organisations are likely to enhance acceptability and participation. More research is required on Indigenous Pacific post-disaster mental health programmes.

Cuidados terapêuticos de agentes da pastoral da sobriedade junto a dependentes químicos / Atención terapéutica de agentes de pastoral de sobriedad para drogadictos / Therapeutic care of agents of sobriety pastoral care for drug addicts

OBJETIVO: conhecer o cuidado terapêutico dos agentes da pastoral da sobriedade junto aos dependentes químicos. MÉTODO: pesquisa exploratória e com abordagem qualitativa, realizada em comunidade religiosa de referência do estado de Mato Grosso, Brasil. A coleta de dados foi realizada entre fevereiro e julho de 2019, mediante entrevista semiestruturada. A análise dos dados ocorreu pela Análise de Conteúdo sob à luz da Teoria de Expansão da Consciência. RESULTADOS: o cuidado desenvolvido pela pastoral gera benefícios que não se restringem apenas aos dependentes e codependentes, mas também aos agentes da pastoral. Entretanto, percebeu-se algumas limitações desse cuidado, associadas ao número de agentes pastorais, ausência de parcerias com outras entidades e/ou pouca compreensão dos agentes frente ao programa dos 12 passos. CONCLUSÃO: evidencia-se a importância do fortalecimento desse cuidado, visto a dificuldade em alcançar/assistir esse grupo vulnerável na comunidade

OBJETIVO: conocer la atención terapéutica de los agentes de pastoal de sobriedad con drogadictos. MÉTODO: investigación exploratoria con un enfoque cualitativo, realizada en una comunidad religiosa de referencia en el estado de Mato Grosso, Brasil. La recolección de datos se realizó entre febrero y julio de 2019 a través de entrevistas semiestructuradas. El análisis de los datos fue realizado por Content Analysis a la luz de la Consciousness Expansion Theory. RESULTADOS: La atención desarrollada por la pastoral genera beneficios que no se limitan a los dependientes y codependientes, sino también a los agentes pastorales. Sin embargo, hubo algunas limitaciones de esta atención, asociadas con el número de agentes pastorales, la falta de alianzas con otras entidades y/o la poca comprensión de los agentes con respecto al programa de 12 pasos. CONCLUSIÓN: Se destaca la importancia de fortalecer esta atención, dada la dificultad de llegar/ayudar a este grupo vulnerable en la comunidad

OBJECTIVE: to know the therapeutic care of the agents of sobriety pastoral care with drug addicts. METHOD: exploratory research with a qualitative approach, conducted in a reference religious community in the state of Mato Grosso, Brazil. Data collection was performed between february and july 2019 through semi-structured interviews. Data analysis was performed by Content Analysis under the light of the Consciousness Expansion Theory. RESULTS: the care developed by pastoral care generates benefits that are not restricted to dependents and codependents, but also to pastoral agents. However, there were some limitations of this care, associated with the number of pastoral agents, lack of partnerships with other entities and/or poor understanding of the agents in the 12-step program. CONCLUSION: the importance of strengthening this care is highlighted, given the difficulty in reaching/assisting this vulnerable group in the community

The requirements of hospital-based spiritual care for cancer patients.

PURPOSE: This paper aimed to discover the requirements of hospital-based spiritual care for cancer patients. METHODS: This study was a descriptive qualitative-exploratory research, in which 25 participants were selected through purposive sampling and had semi-structured interviews. RESULT: The data analysis revealed 3 themes and 8 sub-themes including fundamental requirements (changes in the attitudes and behaviors of the healthcare team), structural requirements (inter-professional collaborations, a reference system), and functional requirements (religious-spiritual, pastoral, psycho-spiritual, and supportive-spiritual care). In this study, the received topics have been related to the spiritual care which can help improve patient care. CONCLUSION: The results were added to the repertoire of knowledge about the spiritual needs of cancer patients. The results indicated that it is essential to get acquainted with the spiritual care requirements in the hospital and enforce them through inter-professional collaboration. Accordingly, the spiritual care program should be designed, implemented, and evaluated.

A Qualitative Examination of VA Chaplains' Understandings and Interventions Related to Moral Injury in Military Veterans.

This study examines VA chaplains' understandings of moral injury (MI) and preferred intervention strategies. Drawing qualitative responses with a nationally-representative sample, content analyses indicated that chaplains' definitions of MI comprised three higher order clusters: (1) MI events, (2) mechanisms in development of MI, and (3) warning signs of MI. Similarly, chaplains' intervention foci could be grouped into three categories: (1) pastoral/therapeutic presence, (2) implementing specific interventions, and (3) therapeutic processes to promote moral repair. Findings are discussed related to emerging conceptualizations of MI, efforts to adapt existing evidence-based interventions to better address MI, and the potential benefits of better integrating chaplains into VA mental health service delivery.

Evaluation of a Chaplain Residency Program and Its Partnership with an In-Patient Palliative Care Team.

In 2009 a Consensus Conference of experts in the field of spiritual care and palliative care recommended the inclusion of Board-certified professional chaplains with at least 1,600 hours of clinical pastoral education as members of palliative care teams. This study evaluates a clinical pastoral education residency program's effectiveness in preparing persons to provide spiritual care for those with serious illness and in increasing the palliative care team members' understanding of the chaplain as part of the palliative care team. Results showed chaplain residents felt the program prepared them to provide care for those with serious illness. It also showed that chaplain residents and palliative care team members view spirituality as an integral part of palliative care and see the chaplain as the team member to lead that effort. Suggested program improvements include longer palliative care orientation period, more shadowing with palliative care team members, and improved communication between palliative care and the chaplain residents.

Handling Stereotypes of Religious Professionals: Strategies Hospice Chaplains Use When Interacting with Patients and Families.

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.

Implementing Integrated Mental Health and Chaplain Care in a National Quality Improvement Initiative.

This column describes the development, implementation, and outcomes of a quality improvement learning collaborative that aimed to better integrate chaplaincy with mental health care services at 14 participating health care facilities evenly distributed across the U.S. Department of Veterans Affairs and Department of Defense. Teams of health care chaplains and mental health professionals from participating sites sought to improve cross-disciplinary service integration in six key domains: screening, referrals, assessment, communication and documentation, cross-disciplinary training, and role clarification. Chaplains and mental health providers across all facilities at participating sites were significantly more likely post-collaboration to report having a clear understanding of how to collaborate and to report using a routine process for screening patients who could benefit from seeing a professional from the other discipline. Foundational efforts to enhance cross-disciplinary awareness and screening practices between chaplains and mental health professionals appear particularly promising.

African-American Congregational Care and Counseling: Transcending Universal and Culturally-Specific Barriers.

This article addresses two major African-American congregational care needs: (1) helping suffering people to access sustained mental health care, particularly in a large/mega-church; and (2) helping suffering people with multi-layered challenges to access appropriate, skilled care that transcends traditional barriers and is consistent with their faith. One model of congregational care is presented with concrete examples of how cultural, theological, and strategic concerns are discussed, with broad implications for diverse faith communities.

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.

You Are Not Alone: PARISH NURSES BRIDGE CHALLENGES FOR FAMILY CAREGIVERS.

In 2015, there were 43.5 million informal, unpaid caregivers in the United States. Caregivers reported a moderate to high level of burden of care, including performing medical and nursing tasks they were not trained to do. A study of family caregiver experiences with parish/faith community nurses reveals four key ways parish nurses support caregivers and offers important implications for parish nurse preparation and practice.

Science Reinforcing Mission. How Can Our Communities Move Ahead After Ferguson?

During Jesus' healing ministry, he addressed the diseases of his day, particularly the conditions that ostracized people, such as demon possession, paralysis, hemorrhage and blindness. This healing ministry is much of our focus in Catholic health care, as it should be. But Jesus addressed the deeper stories that surrounded the people he healed. He challenged his listeners to recognize the role they played in creating their own narrative of disease and their communities' norms in responding to illness. He did not shy away from separating the afflicted person's illness from moral failings or character weakness. He was clear about calling out institutional practices that marginalized people. In short, Jesus called out injustice when he saw it, and his healing was tied up in these social statements.

Priorities for global research into children's palliative care: results of an International Delphi Study.

BACKGROUND: There is an urgent need to develop an evidence base for children's palliative care (CPC) globally, and in particular in resource-limited settings. Whilst the volume of CPC research has increased in the last decade, it has not been focused on countries where the burden of disease is highest. For example, a review of CPC literature in sub Saharan Africa (SSA) found only five peer-reviewed papers on CPC. This lack of evidence is not confined to SSA, but can be seen globally in specific areas, such as an insufficient research and evidence base on the treatment of pain and other symptoms in children. This need for an evidence base for CPC has been recognised for some time, however without understanding the priorities for research in CPC organisations, many struggle with how to allocate scarce resources to research. METHOD: The International Children's Palliative Care Network (ICPCN) undertook a Delphi study between October 2012 and February 2013 in order to identify the global research priorities for CPC. Members of the ICPCN Scientific Committee formed a project working group and were asked to suggest areas of research that they considered to be important. The list of 70 areas for research was put through two rounds of the Delphi process via a web-based questionnaire. ICPCN members and affiliated stakeholders (n = 153 from round 1 and n = 95 from round 2) completed the survey. Participants from SSA were the second largest group of respondents (28.1 % round 1, 24.2 % round 2) followed by Europe. RESULTS: A list of 26 research areas reached consensus. The top five priorities were: Children's understanding of death and dying; Managing pain in children where there is no morphine; Funding; Training; and Assessment of the WHO two-step analgesic ladder for pain management in children. CONCLUSIONS: Information from this study is important for policy makers, educators, advocates, funding agencies, and governments. Priorities for research pertinent to CPC throughout the world have been identified. This provides a much needed starting place for the allocation of funds and building research infrastructure. Researchers working in CPC are in a unique position to collaborate and produce the evidence that is needed.

The Affordable Care Act and hospital chaplaincy: re-visioning spiritual care, re-valuing institutional wholeness.

This article focuses on the institutional dimensions of spiritual care within hospital settings in the context of the Patient Protection and Affordable Care Act of 2010 (ACA), applying policy information and systems theory to re-imagine the value and function of chaplaincy to hospital communities. This article argues that chaplaincy research and practice must look beyond only individual interventions and embrace chaplain competencies of presence, ritual, and communication as foundational tools for institutional spiritual care.