Spring-Summer 2009 Newsletter
On-Line Newsletter Volume 7, Number 3
Published May 29, 2009
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 Fall 2009 issue will be published in late October.)
Table of Contents
- HealthCare Chaplaincy Study of CPE Students
- "Spiritual Skills" Research by Gordon Hilsman
- Update on Projects at the VCU Program in Patient Counseling
- The Chaplain’s Role in Pediatric Palliative Care: Mapping Model Programs
- Summer Workshops on Spirituality & Health Research at Duke University
- Call for Papers on Health Care Chaplaincy
- Second Annual Meeting of the Society for Spirituality, Theology and Health
- Bibliography of Medline-Indexed Articles Published in 2008
1. HealthCare Chaplaincy Study of CPE Students
HealthCare Chaplaincy (New York) has been conducting research and program evaluation for quite some time. Currently, the results of a 3-year evaluation of the Clinical Pastoral Education program are being prepared for publication. In this study of CPE, students completed a questionnaire at the beginning and end of their unit. The questionnaire measured pastoral skills, emotional skills, and ended with a measure of social desirability.
Some brief findings from our study:
These results have some limitations. The sample is self-selected, and just under half of all possible CPE students completed both the pretest and the posttest (144 out of a total of 306 pretests). Current research at HealthCare Chaplaincy is continuing the pretest/posttest design with a measure of pastoral skills that more closely conforms to ACPE standards.
- Students reported statistically significant improvements in pastoral skills over time, especially for students in their first CPE unit.
- Some of the pastoral skills that were reported to have improved were: accessing hospital resources to meet the spiritual needs of patients, comfort levels with praying with patients, and capability to provide spiritual care to Buddhists and Roman Catholic patients. Being aware of one’s own nonverbal cues and one’s personal impact on patients also improved by the end of the CPE unit.
- Social desirability was not related to any improvement in scores, indicating that responses on the questionnaire were not influenced by the desire to look good.
For information about our research, please contact Dr. Kevin J. Flannelly, Associate Director of Research (email@example.com) or Dr. Katherine R. B. Jankowski, Assistant Professor, The College of Pastoral Care (firstname.lastname@example.org). --KRBJ
2. "Spiritual Skills" Research by Gordon Hilsman
What are the crucial characteristics of excellent interdisciplinary team members? What specific skills need to be developed in at least one team member in order for person-oriented medical care to take place? How do health care professionals differ in the ways in which they nurture their own human spirits and contribute to the spirits of those around them? Gordon Hilsman, D.Min., ACPE Supervisor, Franciscan Health System, Tacoma, WA, has conducted survey studies addressing these questions and presented initial findings at the First Annual Spiritual Care Collaborative Summit (2008), introducing the concept of "spiritual skill."
Hilsman worked with Juan Iregui, MD, MA, a palliative care physician and medical ethicist, and Rick MacCornack, PhD, a medical epidemiologist, in conducting and analyzing data regarding a survey instrument of 103 Spiritual Skills. Forty respondents from each of five health care professional groups provided the data for this baseline study. MDs, RNs, managers, chaplains and CPE supervisors showed significant differences in the ways they self-assess four classes of human capacities: interpersonal, personal, metapersonal, and communapersonal skills.
Managers and chaplains fancy themselves as most spiritually skilled overall, with physicians lowest and supervisors barely ahead. Are physicians and supervisors simply more honest regarding such skills as apologizing, requesting, and asking for help? Or are the deficits in each group actually prescriptive indicators for well-designed educational and personal growth arenas in which to assist professionals to become more proficient as basic aspects of human interaction, self care, community involvement, and relationship with The Beyon? Many distinctions were found in this preliminary study, suggesting a need and pointing the way to further, more closely defining research.
Gordon Hilsman can be reached at GordonHilsman@fhshealth.org or at Franciscan Health System in Tacoma WA, 253-426-6735. --GH
3. Update on Projects at the VCU Program in Patient Counseling
An article in Chaplaincy Today reports on research conducted by Virginia Commonwealth University’s Program in Patient Counseling. "Enhancing Student Engagement and Critical Thinking During Hospital Orientation for Level 1 CPE Students" [Tartaglia, Dodd-McCue, Horrocks, and Faulkner, Chaplaincy Today 25, no. 1 (Spring/Summer 2009): available freely online from the Association of Professional Chaplains], presents the results of an innovative video component used to convey orientation material on key hospital issues facing Level 1 chaplains. These innovations, sponsored by a grant from VCU’s Center for Teaching Excellence, are now incorporated into the program’s orientation and have generated interest in replication by other programs.
VCU’s Program in Patient Counseling recently completed a feasibility study on the needs of clergy in Virginia’s Northern Neck. Funded by the Jessie Ball DuPont Fund, the project entailed extensive focus groups, development of a master database of area clergy, a comprehensive survey of clergy, and data analysis identifying clergy needs and possible program delivery methods. The survey results will serve as an evidence-based foundation for future project development and funding. Faculty involved in this project included chaplains Alma Hassell and Tim Ford, Dr. Mark Cooper, Dr. Alexander Tartaglia, and Dr. Diane Dodd-McCue.
Members of VCU’s Program in Patient Counseling faculty assumed a leadership role in a multidisciplinary consortium that recently submitted a grant proposal to the US Department of Health and Human Services, HRSA. The consortium proposed a three-year project to increase donation knowledge and registration by the hospital workforce at VCU Health System. Other members of the consortium include VCU’s School of Medicine and VCU Health System. If funded, Dr. Diane Dodd-McCue would serve as Principal Investigator, with Ken Faulkner and Dr. Alexander Tartaglia, all from VCU’s program, as members of the grant research team.
Angela Duncan, chaplain to VCU’s Pauley Heart Center, is a co-author of "Psychosocial Factors, Quality of Life and Psychological Distress: Ethnic Differences in Patients with Heart Failure," now being revised for Progress in Cardiovascular Nursing. This article reports the research efforts of a multidisciplinary team involved with end stage heart failure patients. In addition to her work as a chaplain, Duncan is a doctoral student in the patient counseling track of VCU’s Allied Health Professions Doctoral Program.
Pediatric chaplain Alma Hassell is a member of the Helping Children of Adult Patients (HCAP) team, recently recognized for it efforts in a poster session for Nursing Week. In addition to the designated pediatric chaplain, the HCAP team includes child life specialists, pediatric nurse practitioners, and pediatric nurses.
Research Basics of Hospital Chaplains is being offered as an elective for Masters Students in the Program in Patient Counseling. The second year this course has been offered, it highlights developing a practical evidence-based proposal within the context of students’ hospital service lines.
For more information, contact Dr. Diane Dodd-McCue at email@example.com or 804-828-3953. --DD-M
4. The Chaplain’s Role in Pediatric Palliative Care: Mapping Model Programs
The Hastings Center, in collaboration with the Department of Religion, Health, and Human Values at Rush University Medical Center, and with funding from Texas Children’s Hospital, is conducting research into The Chaplain’s Role in Pediatric Palliative Care: Mapping Model Programs. The investigators are Nancy Berlinger, PhD, MDiv, from The Hastings Center, and [ACPE Supervisor] George Fitchett, PhD, and Erin Flanagan-Klygis, MD, from Rush University Medical Center.
At present, it is difficult for the nation’s 10,000 chaplains to learn how to assess and improve the quality of the care they provide, including the quality of their work in pediatric palliative care. To fill this research gap and meet this practical need, this one-year project (March 1, 2009-February 28, 2010) will:
Advisors on this study include: Wendy Cadge, PhD, Department of Sociology, Brandeis University; Martha Dimmers, MDiv, MSW, Manager, Pastoral and Spiritual Care Department, Children’s Hospital and Regional Medical Center, Seattle; Deborah Dokken, MPA, Associate Director, Initiative on Pediatric Palliative Care (IPPC); Betty Ferrell, RN, MA, PhD, Research Scientist, City of Hope National Medical Center; Bebe Guill, MDiv, former chaplain, Duke University Medical Center pediatric brain tumor program, now with the Institute for Care at the End of Life at Duke Divinity School; and [ACPE Suprevisor] George Handzo, MDiv, Vice President, Pastoral Care Leadership and Practice, HealthCare Chaplaincy (New York), and former pediatric chaplain, Memorial Sloan-Kettering Cancer Center.
- …identify 15 programs in US health care institutions that have the potential to serve as models for the involvement of chaplains in pediatric palliative care.
- …through interviews and analysis, understand how these programs work and the institutional values and conditions that sustain them.
- …through web-based and print methods, disseminate practical recommendations that chaplain managers can use to improve the quality of their work in pediatric palliative care, and that can contribute to efforts to understand the role of chaplaincy in providing patient-centered care to children and families.
A preliminary report on project findings will be featured at the Conference on Spirituality in Pediatrics: Transforming Care for Children, to be held October 21-23, 2009, in Houston. For more about this conference, visit: www.texaschildrens.org/spirituality.
For more information, contact Nancy Berlinger: firstname.lastname@example.org.
5. Summer Workshops on Spirituality & Health Research at Duke University
The Center for Spirituality, Theology, and Health at Duke University, Durham, North Carolina, will offer two 5-day intensive research workshops -- July 20th-24th and August 17th-21st -- focusing on what we know about the relationship between religion and health, how to apply this knowledge, and how to conduct research and develop an academic career in this area. There are no degree requirements, and all Clergy and interested laypersons are welcome.
Leading religion & health researchers from Duke and other universities will offer an overview of information normally gained as part of a postdoctoral fellowship. Presentations include:
For more information, and to register, go to www.spiritualityhealthworkshops.org. You may also e-mail Dr. Harold Koenig at email@example.com.
- Previous research on religion, spirituality and health
- Strengths and weaknesses of previous research
- Applying findings to clinical practice
- Theological considerations and concerns
- Highest priority studies for future research
- Strengths and weaknesses of religion/spirituality measures
- Designing different types of research projects
- Carrying out and managing a research project
- Writing a grant to NIH or private foundations
- Where to obtain funding for research in this area
- Writing a research paper for publication; getting it published
- Presenting research to professional and public audiences, and working with the media
6. Call for Papers on Health Care Chaplaincy
The Journal of Health Care Chaplaincy is inviting authors to submit scholarly articles based on original research, quality assurance/improvement studies, descriptions of programs and interventions, program/intervention evaluations, and literature reviews on topics pertinent to pastoral care and counselling in relation to physical and mental health. Scholarly articles on all relevant topics will be considered. Topics of particular interest for future issues include:
Authors are encouraged to submit articles having some empirical basis that describe completed or on-going projects, programs, and research. Full-length and brief reports of empirical research (including pilot studies) are especially encouraged. All articles will be peer-reviewed.
- Clinical Pastoral Education -- Training, Evaluation, Outcomes
- Defining and Contrasting Spiritual and Pastoral Care
- Measuring Patients Spiritual and Emotional Needs
- Outcome-Oriented Chaplaincy and Measuring Chaplain Effectiveness
- Spiritual Assessment and Interventions
- Spiritual Distress and Health Outcomes
- Standards of Practice and Best Practices
- The Chaplain as Part of the Interdisciplinary Team
The Journal of Health Care Chaplaincy is an independent journal established in 1987 to promote professional chaplaincy through research and scholarship. It has a worldwide readership and is indexed on Medline. The current publisher is Taylor & Francis, Philadelphia. The journal is not affiliated with HealthCare Chaplaincy, New York. Guidelines for submitting manuscripts can be obtained from the Editor-in-Chief, Kevin J. Flannelly, Ph.D., at firstname.lastname@example.org. --KJF
[Note: the journal has previously been accessible online through Informaworld (vols 1-15), but is now published through Taylor and Francis (vol 16).]
7. Second Annual Meeting of the Society for Spirituality, Theology and Health
The second annual meeting of the Society for Spirituality, Theology and Health will be held June 3-5, 2009, in Durham, NC. The meetings are "designed to bring together transdisciplinary scholars and interested physicians, clergy, chaplains, nurses and laypersons from the United States and other parts of the world to present and discuss the latest research in spirituality, theology, and health" [--from an e-mail announcement by the Center for Spirituality, Theology, and Health]. The theme this year is, Lifecourse Perspectives on Spirituality and Health in Diverse Religious Communities [click for PDF brochure], and members of our Network will be attending.
8. Bibliography of Medline-Indexed Articles Published in 2008
The Department of Pastoral Care at the University of Pennsylvania Health System issues annually a bibliography of Medline-indexed articles on Spirituality & Health published during the previous year. The 2008 bibliography -- now online and accessible as a PDF at www.uphs.upenn.edu/pastoral/resed/bibindex.html -- includes 387 annotated entries, many of which are reports of research. In addition to the studies that we have featured in our Articles-of-the-Month or noted in our Network Newsletters, the following dozen articles from 2008 should not go without notice. They are a sample of what may be found in the larger bibliography.
Berntson, G. G., Norman, G. J., Hawkley, L. C. and Cacioppo, J. T. [Ohio State University, Columbus]. "Spirituality and autonomic cardiac control." Annals of Behavioral Medicine 35, no. 2 (Apr 2008): 198-208. [This study of a representative sample of 229 persons found (from the abstract:) In a population-based sample, spirituality appears to be associated with a specific pattern of CAR (cardiac autonomic regulation), characterized by a high level of cardiac autonomic control, irrespective of the relative contribution of the two autonomic branches. This pattern of autonomic control may have health significance.]
Bormann, J. E., Thorp, S., Wetherell, J. L. and Golshan, S. [VA San Diego Healthcare System and San Diego State University, CA]."A spiritually based group intervention for combat veterans with posttraumatic stress disorder: feasibility study." Journal of Holistic Nursing 26, no. 2 (Jun 2008): 109-116. [This study explored the feasibility of using mantram repetition -- the spiritual practice of repeating a sacred word/phrase throughout the day -- for managing symptoms of posttraumatic stress disorder in a sample of 29 veterans. Among the findings: large effect sizes were found for reducing PTSD symptom severity and psychological distress, and increasing quality of life.]
Copel, L. C . [Villanova University, Villanova, PA]. "The lived experience of women in abusive relationships who sought spiritual guidance." Issues in Mental Health Nursing 29, no. 2 (2008): 115-130. [(From the abstract:) The objective of this qualitative study was to describe the experience of abused women attempting to decrease their spiritual distress and obtain spiritual guidance from their religious leaders. The findings revealed that clergy were not helpful in alleviating the women’s spiritual distress or intervening in the violence. Four themes that epitomized the negative outcomes of the help-seeking behavior were spiritual suffering, devaluation, loss, and powerlessness.]
Dew, R. E., Daniel, S. S., Goldston, D. B. and Koenig, H. G. [Duke University Medical Center, Durham, NC]. "Religion, spirituality, and depression in adolescent psychiatric outpatients." Journal of Nervous and Mental Disease 196, no. 3 (Mar 2008): 247-251. [(From the abstract:) One hundred seventeen psychiatric outpatients aged 12 to 18 completed the brief multidimensional measure of religiousness/spirituality, the Beck Depression Inventory (BDI), a substance abuse inventory. Controlling for substance abuse and demographic variables, depression was related to feeling abandoned or punished by God…, feeling unsupported by one’s religious community…, and lack of forgiveness….]
Farrell, J. L. and Goebert, D. A. [University of Hawaii, Honolulu]. "Collaboration between psychiatrists and clergy in recognizing and treating serious mental illness." Psychiatric Services 59, no. 4 (Apr 2008): 437-440. [This is a report of a survey of 98 Protestant clergy in Hawaii. (From the abstract:) Most (71%) reported feeling inadequately trained to recognize mental illness. The most common cause of mental illness that clergy members cited was medical (37%), yet when asked to comment on two case vignettes, many reported that they would provide counseling instead of referral. When referrals were made, 41% considered shared religious beliefs between parishioner and provider important, and 15% considered shared beliefs essential.]
Gillum, R. F., King, D. E., Obisesan, T. O. and Koenig, H. G. [National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD]. "Frequency of attendance at religious services and mortality in a U.S. national cohort." Annals of Epidemiology 18, no. 2 (Feb 2008): 124-129. [(From the abstract:) In a nationwide cohort of Americans, predominantly Christians, analyses demonstrated a lower risk of death independent of confounders among those reporting religious attendance at least weekly compared to never. The association was substantially mediated by health behaviors and other risk factors.]
Gusick, G. M. [St. Luke’s Episcopal Health System, Houston, TX]. "The contribution of depression and spirituality to symptom burden in chronic heart failure." Archives of Psychiatric Nursing 22, no. 1 (Feb 2008): 53-55. [This report of original research suggests that spirituality may function as a moderator rather then a predictor of symptom burden in heart failure patients. “According to the findings, in the case of depression, spirituality, and (Heart Failure) symptom burden, the relationship between depression and symptom burden varied depending on spirituality” (p. 54).]
Koenig, H. G. [Duke University Medical Center, Geriatric Research, VA Medical Center, Durham, NC]. "Concerns about measuring ‘spirituality’ in research." Journal of Nervous and Mental Disease 196, no. 5 (May 2008): 349-355. [This commentary on measures of spirituality underscores the risk that the concept of spirituality is increasingly measured by attributes of positive mental health, making correlations between spirituality and indicators of good mental health meaningless and tautological.]
McCauley, J., Tarpley, M. J., Haaz, S. and Bartlett, S. J. [Johns Hopkins School of Medicine, Baltimore, MD]. "Daily spiritual experiences of older adults with and without arthritis and the relationship to health outcomes." Arthritis and Rheumatism 59, no. 1 (Jan 15, 2008): 122-128. [Among the findings (from the abstract:) Of 99 patients, 80% reported DSE (Daily Spiritual Experiences) most days and many times per day. …Frequent DSE were significantly associated with a higher number of comorbid conditions…, although not with age, education, or employment status. Persons with arthritis reported significantly more DSE than those without arthritis…. After adjustment for age, race, sex, pain, and comorbid conditions, more frequent DSE were associated with increased energy…and less depression…in patients with arthritis.]
Park, C. L. [University of Connecticut, Storrs]. "Estimated longevity and changes in spirituality in the context of advanced congestive heart failure." Palliative and Supportive Care 6, no. 1 (Mar 2008): 3-11. [Among the findings of this study of 111 patients with advanced congestive heart failure was that (from the abstract:) shifting longevity estimates toward less time or toward uncertainty was related to increases in religious life meaning and forgiveness and to decreased spiritual struggle….]
Siatkowski, R. M., Cannon, S. L. and Farris, B. K. [University of Oklahoma College of Medicine]. "Patients’ perception of physician-initiated prayer prior to elective ophthalmologic surgery." Southern Medical Journal 101, no. 2 (Feb 2008): 138-141. [(From the abstract:) Confidential survey of 567 consecutive patients who were offered prayer by their physician before elective eye surgery. ...Ninety-six percent of patients identified themselves as Christian. At least 90% of Christian patients responded favorably toward their prayer experience…. Among the non-Christian patients, the proportion of negative impressions to the prayer experience ranged from 0 to 25%.]
Wilks, S. E. and Vonk, M. E. [LSU School of Social Work, Baton Rogue, LA]. "Private prayer among Alzheimer’s caregivers: mediating burden and resiliency." Journal of Gerontological Social Work 50, nos. 3-4 (2008): 113-131. [(From the abstract:) This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer’s caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency….]