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Fall 2011 Newsletter
On-Line Newsletter Volume 10, Number 1
Published October 26, 2011
Edited by Chaplain John Ehman, Network Convener
Network members are encouraged to submit articles for upcoming issues.
The Newsletter is published three times a year: Fall, Winter, and Spring-Summer.
(The Winter 2012 issue will be published at the end of February.)
Table of Contents
- Annual Network Business Meeting
- Research Workshops at the 2012 National ACPE Conference
- Call for Information about ACPE Programs that Teach Research
- Ideal Intervention Project (IIP) -- Update, by John J. Gleason
- Ten Articles Especially Useful for Introducing CPE Students to Research
- Four Recent Overviews and Evaluations of Spirituality Measures
- More Websites Linking to Our Network Site
1. Annual Network Business Meeting
Our annual Network meeting will be on Friday, February 10, 2012, from 3:45 to 5:15, at the Sheraton National Hotel, 900 South Orme St., Arlington, VA, as part of the ACPE national conference. Please send any agenda items to john.ehman@uphs.upenn.edu. This will be a time to share projects and interests, discuss how to promote research in the ACPE, consider the content and use of our website, and accomplish necessary business.
2. Research Workshops at the 2012 National ACPE Conference
• TEACHING RESEARCH IN CPE RESIDENCY PROGRAMS
Offered: Thursday, February 9th, 1:00-2:30 and Friday, February 10th, 1:45-3:15
Presenters: George Fitchett and Patricia Murphy, from Rush University Medical Center, Chicago, IL; Paul Derrickson, from Milton S. Hershey Medical Center, Hershey, PA; and Alexander Tartaglia and Diane Dodd-McCue, from Virginia Commonwealth University Health System, Richmond, VA
Description: While research was central for Anton Boisen, one of the founders of CPE, in a recent national survey we found only a small minority of CPE residency programs include any education about research. In this workshop we will describe three levels of engagement with research, research literacy, research involvement, and research leadership, and will propose that the future of health care chaplaincy requires that all health care chaplains must be research literate. CPE residency programs play a key role in educating chaplains about research. We will: 1) describe results from our survey of research education in CPE residency programs, and 2) describe curricula that illustrate educating CPE residents for research literacy as well as research involvement and leadership. The workshop will also include time for participants to share information about their research education curricula. Objectives: At the completion of this workshop participants will:
-- be familiar with three levels of engagement with research: research literacy, research involvement, and research leadership;
-- be familiar with the case for research literacy for all chaplains as expressed in Standard 12 of the APC Standards of Practice;
-- be aware of the current state of teaching about research in ACPE residency programs; and
-- be familiar with examples of curricula that will help CPE residents develop research literacy, research involvement, and/or research leadership.
• SELF ASSESSED SPIRITUAL SKILL CHANGES REPORTED BY CPE RESIDENTS AND INTERNS
Offered: Friday, February 10th, 1:45-3:15
Presenter: Gordon J. Hilsman, from Franciscan Health System, Tacoma, WA
Description: How do CPE students perceive their positive changes through completing internship and residency programs? How do they assess the level of their spiritual skills as compared to the self-assessments of certified chaplains, health care managers, registered nurses, physicians and CPE supervisors? Spiritual skills are "developed capacities to care for their own human spirits and those of the people around them." This workshop reports on a study of student self-assessment of 103 Spiritual Skills before and after single-unit and residency CPE programs. It compares this data to previous data gathered from self-assessments of the same skills by physicians, registered nurses, health care managers, certified chaplains, and CPE supervisors. Workshop participants will be asked to complete the study survey instrument before considering and discussing the study results.
• NOTE: Network member John Gleason (ACPE Supervisor Emeritus, Greenwood, IN) is also presenting a workshop at the conference, on the topic of SELF SUPERVISION OF WORK WITH STUDENTS, during the February 10th, 1:45-3:15 time slot.
3. Call for Information about ACPE Programs that Teach Research
George Fitchett (Rush University Medical Center, Chicago, IL) and colleagues are interested in learning more about the curricula of ACPE-accredited centers that include teaching about research in the residency programs. If you include such teaching in your program please e-mail him at george_fitchett@rush.edu or call 312-563-4801.
4. Ideal Intervention Project (IIP) -- Update, by John J. Gleason
The Ideal Intervention Project (IIP), underway since 2006, has as its overall purpose improving the quality of Spiritual Care (SC). Specific uses of the SC Knowledge Base, hosted online by the ACPE Research Network, are: 1) provision of insights from its samples to those ministering in similar situations; 2) consolidation of learning through disciplined writing; 3) submission of that material to the Knowledge Base editor for anonymous inclusion after writer-approved revision; 4) education of decision-makers; 5) documentation of competencies for certification; 6) justification of Medicare reimbursement; and 7) ultimately, assessment of effectiveness of sample replications in the identification of evidence-based SC best practices.
The IIP’s SC Knowledge Base has now passed the 200-sample mark. Workshop presentations this year were as follows:
- 3/24/11 -- "Sharing Spiritual Care Knowledge for the Good of All," at the national APC Conference in Dallas, Texas
- 5/21/11 -- "Sharing Spiritual Care Knowledge for the Good of All," at the national NACC Conference in Milwaukee, Wisconsin
- 9/20/11 -- "Improving Your Pastoral Care--Painlessly," at a regional ABCUSA Ministers Council Retreat in Franklin, Indiana
Two workshops and a Professional Development Intensive are scheduled to date for presentation in 2012:
- 1/15/12 -- "Excellence Plus Job Security," at the Adventist Chaplains Gathering in Tampa, Florida
- 2/10/12 -- "Self-Supervision of Work with Students," at the national REM/ACPE Conference in Arlington, Virginia
- 6/21/12 or 6/24/12 -- "A Case Self-Supervision Model," at the national APC Conference in Schaumburg, Illinois
In an important recent development, planners are preparing to pilot an effectiveness questionnaire in Scotland that is a complete fit with the second phase of the IIP. Three U.S. hospitals will be cooperating with the Scots in piloting the questionnaire.
Finally, a draft proposal is in the works to advance the IIP with help from a HealthCare Chaplaincy/John Templeton Foundation grant. A call for proposals is to be issued in December.
Your participation is not only welcomed; it is needed… so you can reflect upon your teaching and caregiving, contribute to the Knowledge Base, and ultimately help to identify SC best practices, thereby meeting the criteria of decision-makers and ensuring a continuing place for SC professionals on clinical teams in the new U.S. healthcare pay-for-results paradigm.
Reverend John J. Gleason, DMin, BCC (Retired), is an ACPE Supervisor Emeritus and the IIP Coordinator and Editor.
5. Ten Articles Especially Useful for Introducing CPE Students to Research
For the past 14 years, the CPE Residency program at the Hospital of the University of Pennsylvania (Philadelphia) has included a monthly "Research and Literature Seminar." The main purpose is not to teach students to become researchers (though some students have shown an interest in that pursuit), but rather to equip them generally to read and use in their professional lives the wealth of research currently being published -- to become "research literate" -- and to help them think critically about issues of methodology and the dynamics of science as way of knowing for chaplains. Each session revolves around an article. Over the years some articles have proven particularly successful in engaging students, and ten that seem to be especially useful for introducing first-year CPE residents to research have been posted at www.acperesearch.net/articles_for_teaching.html, as part of our web section on Incorporating Research into CPE. What appears to make articles particularly useful is a combination of subject matter that students can relate to personally or vividly and a writing style that is inviting to non-researchers.
If other programs have found some articles to be especially useful in this regard, please share your experience: email john.ehman@uphs.upenn.edu. --" J.E.
6. Four Recent Overviews and Evaluations of Spirituality Measures
The following four articles provide a quite comprehensive survey of measures of spirituality and should offer helpful guidance for researchers considering the menu of options for instruments. Taken together, these articles also paint an interesting picture of the state of the science. They are listed in reverse chronological order.
Meezenbroek, E. de J., Garssen, B., van den Berg, van Dierendonck, D., Visser, A. and Schaufeli, W. B.
"Measuring spirituality as a universal human experience: a review of spirituality questionnaires." Journal of Religion and Health 51, no. 2, (2012): 336-354. [This is an open access article.]
The authors discuss ten measures that "address spirituality as a universal human experience" and evaluate them "with regard to psychometric properties, item formulation and confusion with well-being and distress." [Manuscript p. 1, Abstract] The instruments are divided into two groups:
One- or Two-dimensional Spirituality Questionnaires:
- Spiritual Well-Being Scale of the Functional Assessment of Chronic Illness Therapy (FACIT-Sp) -- Brady, et al., 1999
- Spirituality Subscale of the Mental, Physical and Spiritual Well-being Scale (MPS) -- Vella-Brodrick and Allen, 1995
- Self-Transcendence Scale -- Reed, 1991
- Spiritual Well-being Scale (SWB) -- Ellison, 1983
Multidimensional Questionnaires:
- Prague Spirituality Questionnaire (PSQ) -- Rican and Janosova, 2005
- Spirituality Assessment Scale (SAS) -- Howden, 1992
- Spiritual Involvement and Beliefs Scale Revised Version (SIBS-R) -- Hatch, personal communication, 2007; and (re: SIBS) Hatch, et al., 1998
- Spiritual Transcendence Scale -- Piedmont 1999
- Spiritual Well-Being Questionnaire (SWBQ) -- Gomez and Fisher, 2003
- WHOQOL Spirituality, Religion and Personal Beliefs (WHOQOL SRPB) -- O’Connell, et al., 2006
A brief, summary discussion follows each group of questionnaires. The authors clearly prefer the multidimensional questionnaires and conclude that the Spiritual Well-Being Questionnaire and the Spiritual Transcendence Scale have the best psychometric qualities. Overall, they recommend the Spiritual Well-Being Questionnaire as the "most promising," in spite of the fact that "its reliability and validity are still to be proven in a [non-student] population sample." [Manuscript p. 14]
Monod, S., Brennan, M., Rochat, E., Martin, E., Rochat, S. and Bula, C. J. "Instruments measuring spirituality in clinical research: a systematic review." Journal of General Internal Medicine 26, no. 11 (November 2011): 1345-1357.
"This study's aims were to identify instruments used in clinical research that measure spirituality, to propose a classification of these instruments, and to identify those instruments that could provide information on the need for spiritual intervention. ...For each instrument identified, measured constructs, intended goals, and data on psychometric properties were retrieved. A conceptual and a functional classification of instruments were developed. RESULTS: Thirty-five instruments were retrieved and classified into measures of general spirituality (N=22), spiritual well-being (N=5), spiritual coping (N=4), and spiritual needs (N=4) according to the conceptual classification. " [p. 1345, Abstract] "Quality scores assessing the comprehensiveness of the instrument development and validation process revealed that most instruments had good scores, but only three had a perfect score...(i.e., The Ironson-Woods Spirituality/Religiousness Index, The Spiritual Well-Being Scale, and The Spirituality Index of Well- Being...." [pp. 1348-1349] "Only three instruments have at least half of their items focusing on current spiritual state. Two of these instruments have a spiritual well-being construct (i.e., the FACIT-Sp and the Spirituality Index of Well-being) and are intended to assess the patient’s level of spiritual well-being. These two instruments underwent an extensive validation process.... One instrument has a spiritual needs construct (the Spiritual Needs Inventory). However, this instrument underwent a less accurate validation process.... In conclusion, the FACIT-Sp and the Spirituality Index of Well-being clearly emerged as the most well-validated instruments for the assessment of a patient’s current spiritual state." [p. 1355] Instruments evaluated were:
- The Spiritual Perspective Scale -- Reed, 1986
- The Daily Spiritual Experience Scale -- Underwood, 2002
- Spirituality Assessment Scale -- Howden, 1992
- The Multidimensional Measure of Religiousness/Spirituality (Full and Brief Versions) -- Fetzer Institute National Institute on Aging, 1999; Idler, 2003; Stewart, 2006
- The Spiritual Involvement and Beliefs Scale (SIBS) -- Hatch, 1998
- The Index of Core Spiritual Experience (INSPIRIT) -- Kass, 1991
- The Spiritual Transcendence Scale -- Piedmont, 1999
- The Spiritual Health Inventory (SHI) -- Veach, 1992; Korinek, 2004
- The Royal Free Interview for Religious and Spiritual Beliefs (Interview-based and Self-Report) -- King, 1995; King, 2001
- The Spirituality Scale -- Delaney C, 2005
- SpREUK (Erfassung der Spirituellen und Religösen Einstellung und des Umgangs mit Krankheit) (29- and 25-item versions) -- Ostermann, 2004; Bussing, 2005
- Spirituality and Spiritual Care Rating Scale -- McSherry, 2002; Wallace, 2007
- The Brief Pictorial Instruments for Assessing Spirituality -- LeBron McBride, 1998
- The Higher Power Relationship Scale -- Rowan, 2006
- Orientation toward Religion and Spirituality Index -- Goldfarb, 1996; Galanter, 2006
- The Expressions of Spirituality Inventory -- MacDonald, 2000
- The Spiritual Experience Index -- Genia, 1997
- The Ironson-Woods Spirituality/Religiousness Index (short form) -- Ironson, 2002
- The Beliefs and Values Scale -- King, 2006
- The Spiritual Beliefs Questionnaire -- Christo, 1995
- The Spiritual Transcendence Index -- Seidlitz, 2002
- The Intrinsic Spirituality Scale -- Hodge, 2003
- The Functional Assessment of Chronic Illness Therapy - Spiritual Well-Being Scale (FACIT-Sp) -- Brady, 2002; Peterman, 2002
- The Spiritual Well-Being Scale (SWBS) -- Ellison, 1983
- WHOQOL SRPB -- World Health Organization's WHOQOL SRPB Group, 2006
- JAREL (spiritual well-being scale) -- Hungelmann, 1998
- The Spirituality Index of Well-Being (SIWB) -- Daaleman, 2002 and 2004
- The System of Beliefs Inventory (SBI-15) -- Holland, 1998
- A Semi-Structured Clinical Interview for Assessment of Spirituality and Religious Coping for Use in Psychiatric Research -- Mohr, 2007
- The Spiritual Strategies Scale -- Nelson-Becker, 2005
- The Spiritual Support Scale -- Ai, 2005
- Spiritual Needs Inventory -- Hermann, 2006
- The spiritual interests related to illness tool (spIRIT) -- Taylor, 2006
- The Spiritual Needs Scale -- Yong, 2008
- The Spiritual Needs Questionnaire -- Bussing, 2010
"Findings underscore the scarcity of instruments specifically designed to measure a patient's current spiritual state. Moreover, the relatively limited data available on psychometric properties of these instruments highlight the need for additional research to determine whether they are suitable in identifying the need for spiritual interventions." [p. 1345, Abstract] The authors make a special point of the need to develop instruments that measure changes in one's spiritual state over time.
Sessanna, L., Finnell, D. S., Underhill, M., Chang, Y.P. and Peng, H. L "Measures assessing spirituality as more than religiosity: a methodological review of nursing and health-related literature." Journal of Advanced Nursing 67, no. 8 (August 2011): 1677-1694.
This is a methodological review of ten English-language measures that purport to consider spirituality as more than religiosity. Analysis included validity, reliability, definition and construct clarity, setting, user-centeredness, and clinical utility and practicality. Total "quality" scores are presented in a table on p. 1681. Other very helpful tables are those summarizing basic information about author, publication, purpose and definition (pp. 1682-1683) and the various measures' psychometrics (pp. 1684-1688). The measures evaluated were:
- Daily Spiritual Experience Scale (DSES) -- Underwood and Teresi, 2002
- Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp, Version 4) -- Peterman, et al., 2002
- Geriatric Spiritual Well-being Scale (GSWS) -- Dunn, 2008
- JAREL Spiritual Well-being Scale (JAREL) -- Hunglemann, et al., 1996
- Spiritual Health Inventory-Patient Inventory (SHI) -- Highfield, 1992
- Spiritual Involvement and Beliefs Scale (SIBS) -- Hatch, et al., 1998
- Spirituality Index of Well-Being (SIWB) -- Daaleman and Frey, 2004
- Spiritual Perspective Scale (SPS) -- Reed, 1986 and 1987
- The Spirituality Scale (SS) -- Delaney, 2005
- Spiritual Well-Being Scale (SWBS) -- Ellison, 1983
The scales with the highest total "quality" scores were the Spirituality Index of Well-Being (SIWB), the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), the Daily Spiritual Experience Scale (DSES), and the Spirituality Scale (SS). The two scales evaluated as strongest when considering only validity and reliability were the Spirituality Index of Well-Being (SIWB) and the Spirituality Scale (SS). Among the main points in discussing the measures: "Despite agreement among nursing and health-related disciplines that spirituality and religiosity are distinct and diverse concepts, the concept of spirituality was often used interchangeably with the concept religion to assess and evaluate patient spirituality. ...Measures differentiating spirituality from religiosity are grossly lacking in nursing and health-related literature." [p. 1677, Abstract]
Selman, L., Harding, R., Gysels, M., Speck, P. and Higginson, I. J.
"The measurement of spirituality in palliative care and the content of tools validated cross-culturally: a systematic review." Journal of Pain and Symptom Management 41, no. 4 (April 2011): 728-753.
"This systematic review aimed to identify and categorize spiritual outcome measures validated in advanced cancer, human immunodeficiency virus (HIV), or palliative care populations; to assess the tools' cross-cultural applicability; and for those measures validated cross-culturally, to determine and categorize the concepts used to measure spirituality. ...Tools were evaluated according to two criteria: 1) validation in advanced cancer, HIV, or palliative care and 2) validation in an ethnically diverse context. Tools that met Criterion 1 were categorized by type; tools that also met Criterion 2 were subjected to content analysis to identify and categorize the spiritual concepts they use. RESULTS: One hundred ninety-one articles were identified, yielding 85 tools. Fifty different tools had been reported in research studies; however, 30 of these had not been validated in palliative care populations. Thirty-eight tools met Criterion 1: general multidimensional measures (n=21), functional measures (n=11), and substantive measures (n=6). Nine measures met Criterion 2; these used spiritual concepts relating to six themes: Beliefs, practices, and experiences; Relationships; Spiritual resources; Outlook on life/self; Outlook on death/dying; and Indicators of spiritual well-being. ...The nine tools identified in this review are those that have currently been validated in cross-cultural palliative care populations and, subject to appraisal of their psychometric properties, may be suitable for cross-cultural research." [p. 728, Abstract] The nine recommended tools are:
- Beck Hopelessness Scale
- Existential Loneliness Questionnaire
- EMS [existential meaning]
- Ironson-Woods Spirituality/Religiousness Index Short Form
- McGilll Quality of Life Questionnaire
- Missoula-VITAS Quality of Life Index
- Palliative Care Outcome Scale
- QUAL-E [quality of life at the end of life]
- WHOQOL-HIV BREF [World Health Organization quality-of-life]
[Note (added 2/28/12): For another review of instruments, see the Winter 2012 Newsletter, §10.]
7. More Websites Linking to Our Network Site
Our Research Network website continues to receive attention by others on the Internet. Among new sites linking to our online material: The UK Board of Healthcare Chaplaincy, an interfaith organization in the United Kingdom, posted a notice about Steve Nolan's research on chaplains' work with dying patients, linked to our February 2011 Article-of-the-Month, which highlighted his article. The same Article-of-the-Month also caught the interest of a university student in Kiev, Ukraine: Sofya Kravchuk. She wrote to the Network, asking for permission to translate that web page into Belorussian and post it on her blog devoted to research and developments in medicine and biology. In addition, the organization, Palette of Faith, which serves a coalition of health care and faith community leaders dedicated to meeting the holistic needs of patients and families facing end-of-life issues, has added our site to its listing of "Helpful Websites." As you come across links to our website, please notify the Convener.
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