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Spring/Summer 2007 Newsletter

On-Line Newsletter Volume 5, Number 3
Published June 6, 2007

Edited by Chaplain John Ehman, Network Convener

Network members are encouraged to submit articles for upcoming issues
of the Newsletter, which is published three times a year: Fall, Winter, and Spring-Summer.
Fall 2007 issue is scheduled to be posted in October.


Table of Contents

  1. Update on the Ideal Intervention Paper (IIP) Project
  2. CPE Student Survey of PCA and OPC Chaplains
  3. Research on Chaplain-to-Patient Bed Ratios
  4. What Do Patients Want That They're Not Getting?
  5. Clarification about the Spiritual Needs Assessment Scale
  6. Center for Study of Health, Religion, and Spirituality at Indiana State University
  7. Duke's Center for Spirituality, Theology, and Health Revises Its Website
  8. New Bibliography of Articles on Spirituality and Health from 2006


1.     Update on the Ideal Intervention Paper (IIP) Project

Last year, John J. Gleason, ACPE Supervisor Emeritus, piloted the Ideal Intervention Paper (IIP) as part of a CPE unit at St. Vincent Hospital in Indianapolis, IN. (For information about student feedback from that initial pilot phase, see §5 of the Fall 2006 Newsletter, and for more on the project itself, see §5 of the Spring 2006 Newsletter.] Now, thanks to Dr. Gleason's continuing efforts, six other supervisors in the East Central Region will be incorporating the project into their programs. Students will be challenged to "experience a deeper level of learning through a second round of verbatim study...while at the same time contributing to [an] important best practices effort" --a memo to students being titled "Verbatim to the Second Power: A Best Practices Protocol for CPE Students" [and available as a PDF by clicking here]. With further feedback from this next pilot phase, we should be able to gain a good sense of how the project may be enriching to students while helping to build a body of material from which to develop best practices in chaplaincy.

Any CPE Supervisors interested in incorporating the "Verbatim2" exercise into their curricula should contact Research Network Convener John Ehman (


2.     CPE Student Survey of PCA and OPC Chaplains

As part of his CPE Residency at the Hospital of the University of Pennsylvania, Rev. James Pfeiffer investigated the CPE experience of chaplains from the Presbyterian Church in America and Orthodox Presbyterian Church. He has provided the following abstract:

A survey was sent to 189 chaplains of the Presbyterian Church in America and Orthodox Presbyterian Church, with 60 responding and 36 completing the survey. The aim of the project was to discover how many chaplains in the PCA and OPC have taken CPE units and to gauge their response to CPE as an effective tool for pastoral education. The results indicated a strong appreciation of the role of CPE in contributing significantly to participants' preparation for effective ministry in a multi-faith environment. While respondents generally noted a theological divergence of CPE from the conservative theology of their denominations, they overwhelmingly cited the benefits of the program in all of its parts and strongly endorsed its usefulness for others in their denominations.

The survey was made available to participants as an on-line form through the University of Pennsylvania Department of Pastoral Care. The project appears to hold good insight into the experience of PCA and OPC graduates of CPE, and Rev. Pfeiffer is currently in the process of writing up the results for possible publication. For more information, e-mail:


3.     Research on Chaplain-to-Patient Bed Ratios

In the May-June issue of Dimensions of Critical Care Nursing (vol. 26, no. 3, pp. 91-95), Chaplain Brian Hughes, from Banner Good Samaritan Medical Center's Spiritual Care Department, along with nurses Mary Whitmer and Susan Hurst also from BGSMC, have written, "Innovative solutions: a plurality of vision. Integrating the chaplain into the Critical Care Unit." The article is of interest for its description of the role of the chaplain and its perspective on pastoral work in Critical Care Units, but it also contains the following brief report of unpublished research on chaplaincy staffing:

In 2003, a staff chaplain at Banner Good Samaritan Medical Center (BGSMC) contacted the Pastoral Care Department at each facility that had attained Magnet status as of that date to inquire about chaplain staffing to bed ratios (FTEs and Average Daily Census were used to determine these 2 numbers). Of 108 Magnet facilities when the survey was conducted, 101 were ultimately contacted by telephone. The unpublished result of that survey yielded a ratio of 1:153. This ratio can be used as a benchmark to determine staffing needs for a pastoral care department. [p. 92]

What stands out here is that this was a survey of hospitals which had attained Magnet-status, and that program (from the American Nurses Credentialing Center) emphasizes spiritual issues in matters of communication, education, health promotion, assessment of illness, pain management, developmental/behavioral issues, the nurse-patient relationship, and in gerontological and pediatric nursing. One might expect that Magnet-status hospitals would evidence relatively strong support for chaplaincy. However, the 1:153 chaplain-to-patient bed ratio reported by Hughes, et al. as a useful "benchmark" seems--at least to this reader--to indicate a very meager level of pastoral coverage. It also compares poorly to earlier research by Larry VandeCreek, et al., who looked at a broad array of hospital types --see, VandeCreek, L., Gorey, E., Siegel, K., Brown, S. and Toperzer, R., "How many chaplains per 100 inpatients? Benchmarks of health care chaplaincy departments," Journal of Pastoral Care and Counseling 55, no. 3 (Fall 2001): 289-301. This is a very practical subject for chaplains, and one in which continuing research is clearly needed.   --JE


4.     What Do Patients Want That They're Not Getting?

A poster presentation of a study by Aimee Williams of Press Ganey Associates, "What Do Patients Want That They're Not Getting — A Study of Patients from the United States, Canada & Australia," has been published online by Press Ganey. [Note (added 2/22/14): the file is no longer available on the website.]. It was originally presented at the 5th International Conference on the Scientific Basis of Health Services, Washington, D.C., 2003. The analysis of over two million Press Ganey Patient Satisfaction Surveys from the US, along with surveys from Canada and Australia, looked particularly at data calculated as the Press Ganey Priority Index, which highlights survey items with low mean scores and with high correlations to patients' "overall rating of care given at the hospital" --the Priority Index thus indicating those "areas with the largest opportunity for improvement" for a hospital from a patient-satisfaction perspective. Williams found that the survey item, "Degree to which hospital staff addressed your emotional/spiritual needs," was the top-ranked Priority Index item for all three countries. [It is worth noting that the "staff addresses emotional/spiritual needs" item was a standard item in 2003 but has since been changed simply to "staff addresses emotional needs." While many hospitals also include an item specifically about pastoral care, it is non-standard.   --JE]


5.     Clarification about the Spiritual Needs Assessment Scale

Kevin J. Flannelly, Kathleen Galek, and Laura T. Flannelly published in the July/August 2006 issue of Holistic Nursing Practice (vol. 20, no. 4, pp. 187-190), "A test of the factor structure of the Patient Spiritual Needs Assessment Scale," refining the scale originally presented in the journal's March/April 2005 issue (vol. 19, no. 2, pp. 62-69) in "Assessing a patient's spiritual needs: a comprehensive instrument" [which was reviewed as one of our June 2005 Articles-of-the-Month]. There has since been some confusion about the instrument, because of a typographical error and some unclear wording in the "Test of the Factor Structure…" article. In a personal communication with the Research Network, Kevin Flannelly has provided clarification.

While the "Test of the Factor Structure..." article makes reference to a 24-item instrument, Dr. Flannelly relates that the 23-item instrument outlined in Table 1 on p. 188 represents the actual content of the refined instrument. Also, he clarifies an apparent discrepancy between the abstract and the body of the article: with the abstract stating "the results provided strong support for 4 of the 6 dimensions" [p. 187], while the Discussion section begins, "The results provide support for 5 of the 6 dimensions of spiritual needs that were proposed in the assessment scale..." [p. 189]. Dr. Flannelly comments, "5 of the 6 dimensions are supported, but there is strong support for only 4."

The scale in question holds good potential for both research and clinical use, and it is indicative of the dedicated work of Dr. Flannelly and his colleagues at The HealthCare Chaplaincy (New York).


6.     Center for the Study of Health, Religion, and Spirituality at Indiana State University

Founded in 2003, the Center for the Study of Health, Religion, and Spirituality at Indiana State University works "to draw on the best in psychological and behavioral science methods to understand and illuminate the universal value and meaning of religious and spiritual experience, particularly as it promotes health and well-being" [--from the Center's home page]. The website gives information about conferences and other events, many of which may be of widespread and cross-disciplinary interest, such as the upcoming (Fall 2007) National Conference on Meditation and Spirituality: Scientific, Conceptual, and Applied Perspectives. Presentations are also available for download.

Research at the center includes a project on "Integrating Spirituality into Health care Interventions," and programs on "Mindfulness Meditation Research," "Spirituality and Addictive Behaviors," and "Forgiveness, Altruism, and Aggression." Descriptions of the research contain helpful bibliographies of articles on interest.

The Links page is brief and somewhat out of date, and material from conferences is not complete, but the site is well worth watching, and the Center's programs and staff may be good resources for chaplain researchers. CPE supervisors and students from programs close to Terre Haute may especially wish develop a relationship with the Center.


7.     Duke's Center for Spirituality, Theology, and Health Revises Its Website

The Center for Spirituality, Theology, and Health at Duke University has recently revised its website and now emphasizes requests for research proposals on how religion/spirituality influences individual and community health. This may be of special interest to advanced chaplain researchers or chaplains working with advanced research teams. Chaplains should also take note of information on the Center's Summer Research and Clinical Workshops.

The Center's website was originally reviewed in our Fall 2004 Newsletter (§3).


8.     New Bibliography of Articles on Spirituality and Health from 2006

This editor's annual bibliography of Medline-indexed articles on spirituality & health published during 2006 is now on-line as a PDF (64 pages) at . This year's includes abstracts or notes on 407 articles, selected from the more than 1,400 that are indexed for the year in Medline, under the the subject headings of "Religion and Medicine," "Religion and Psychology," "Religion," "Spirituality," and "Pastoral Care." A full series of annual bibliographies from 1999 to 2006 is available through the Hospital of the University of Pennsylvania's Department of Pastoral Care. For background information, see §1 of the Fall 2005 Newsletter.

Consider the following sample of a dozen articles from 2006 that have not previously been noted on the Research Network website:

Benjamins, M. R. [Mt. Sinai Hospital, Chicago, IL]. "Religious influences on trust in physicians and the health care system." International Journal of Psychiatry in Medicine 36, no. 1 (2006): 69-83.

Bowen, R., Baetz, M. and D'Arcy, C. [University of Saskatchewan, Saskatoon, Saskatchewan, Canada]. "Self-rated importance of religion predicts one-year outcome of patients with panic disorder." Depression & Anxiety 23, no. 5 (2006): 266-273.

Cotton, S., Zebracki, K., Rosenthal, S. L., Tsevat, J. and Drotar, D. [VA Medical Center, Cincinnati, OH]. "Religion/spirituality and adolescent health outcomes: a review." Journal of Adolescent Health 38, no. 4 (Apr 2006): 472-480.

Curlin, F. A., Serrano, K. D., Baker, M. G., Carricaburu, S. L., Smucker, D. R. and Chin, M. H. [University of Chicago]. "Following the call: how providers make sense of their decisions to work in faith-based and secular urban community health centers." Journal of Health Care for the Poor & Underserved 17, no. 4 (Nov 2006): 944-957.

Daaleman, T. P. and Kaufman, J. S. [University of North Carolina at Chapel Hill]. "Spirituality and depressive symptoms in primary care outpatients." Southern Medical Journal 99, no. 12 (Dec 2006): 1340-1344.

Dervic, K., Grunebaum, M. F., Burke, A. K., Mann, J. J., Oquendo, M. A. [New York State Psychiatric Institute, and Columbia University, New York]. "Protective factors against suicidal behavior in depressed adults reporting childhood abuse." Journal of Nervous & Mental Disease 194, no. 12 (Dec 2006): 971-974.

Gillum, R. F. and Ingram, D. D. [Centers for Disease Control and Prevention, Hyattsville, MD]. "Frequency of attendance at religious services, hypertension, and blood pressure: the Third National Health and Nutrition Examination Survey." Psychosomatic Medicine 68, no. 3 (May-Jun 2006): 382-385.

Hall, D. E. [University of Pittsburgh Medical Centers]. "Religious attendance: more cost-effective than Lipitor?" Journal of the American Board of Family Medicine 19, no. 2 (Mar-Apr 2006): 103-109.

Hamrick, N. and Diefenbach, M. A. [Indiana University School of Medicine]. "Religion and spirituality among patients with localized prostate cancer." Palliative & Supportive Care 4, no. 4 (Dec 2006): 345-355.

McConnell, K. M., Pargament, K. I., Ellison, C. G. and Flannelly, K. J. "Examining the links between spiritual struggles and symptoms of psychopathology in a national sample." Journal of Clinical Psychology 62, no. 12 (Dec 2006): 1469-1484.

Tarakeshwar, N., Vanderwerker, L. C., Paulk, E., Pearce, M. J., Kasl, S. V. and Prigerson, H. G. [Yale University School of Medicine, New Haven, CT]. "Religious coping is associated with the quality of life of patients with advanced cancer." Journal of Palliative Medicine 9, no. 3 (Jun 2006): 646-657.

Taylor, E. J. [Loma Linda University]. "Prevalence and associated factors of spiritual needs among patients with cancer and family caregivers." Oncology Nursing Forum 33, no. 4 (Jul 2006): 729-735.


If you have suggestions about the form and/or content of the site, e-mail Chaplain John Ehman (Network Convener) at .
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The ACPE Research Network. All rights reserved.