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Spring-Summer 2010 Newsletter

On-Line Newsletter Volume 8, Number 3
Published June 28, 2010

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 2010 issue will be published in October.)

 

Table of Contents

  1. ACPE Board Moves to Develop Research Initiative
  2. Research on Research
  3. Update on Research at Virginia Commonwealth University
  4. Neuropsychology/Neuropsychiatry of Religion --Study Update
  5. New and Proposed Sections of the Network Website
  6. Convener's Report of the Spring 2010 Network Meeting, Kansas City, MO
  7. Research from 2009 Not Previously Noted on the Research Network Website

 

1.     ACPE Board Moves to Develop Research Initiative

The ACPE Board has passed the following motion:

Move that the ACPE appoint the Executive Director to work with interested ACPE Supervisors and Centers and other research experts to design a research initiative for the ACPE.
Executive Director Teresa Snorton, who encouraged this motion, is currently in the process of consulting with our Network regarding strategies for developing the initiative. Any and all ideas are welcome about action plans for the motion, about particular research projects, and about how to involve the ACPE membership at large in research. Please send your suggestions to the Network Convener at john.ehman@uphs.upenn.edu (--all communication will be collected and communicated to Dr. Snorton).

 

2.     Research on Research

Faculty at Rush University and Virginia Commonwealth University are surveying accredited residency centers to identify how they are addressing training opportunities to facilitate research. This project is in response to the Association for Professional Chaplains recently adopted of Standards of Practice for Professional Chaplains in Acute Care Settings. Section 3 Standard 12 reads:

Research: The Chaplain practices evidence-based care including evaluation of new practices, and when appropriate, contributes to or conducts research.
Results will be available through the ACPE Research Network and related outlets. Information on this project is available from Diane Dodd-McCue (ddoddmccue@vcu.edu), George Fitchett (George_Fitchett@rush.edu), Pat Murphy (Patricia_Murphy@rush.edu), and Lex Tartaglia (aftartag@vcu.edu).

 

3.     Update on Research at Virginia Commonwealth University

Recent articles by Patient Counseling faculty focus on research methodology and pastoral education pedagogy. "Self-report Response Bias: Learning How to Live with Its Diagnosis in Chaplaincy Research," by Dr. Diane Dodd-McCue and Dr. Alexander Tartaglia, appeared in the Spring/Summer 2010 issue of Chaplaincy Today. The authors' review of research published in The Journal of Pastoral Care and Counseling between 1998-2008 found that all but one of the 38 research articles used self-report data. Of this total, less than half acknowledged methodological limitations and only two acknowledged the potential impact of self-report response bias. Their article focuses on categories of self-report response bias and recommendations to address this bias to enhance methodological rigor and interpretation of results.

"Enhancing Objectivity in Pastoral Education: Use of Standardized Patients in Video Simulation" will appear in the forthcoming Summer 2010 issue of The Journal of Pastoral Care and Counseling. Written by Tartaglia and Dodd-McCue, the article describes the use of a systematic evaluation of a simulated patient encounter in developing pastoral care interview skills. Using standardized patient scenarios, student progress was assessed using an interview checklist that measured technique categories and their frequency of usage. Although findings suggest student interview improvements, the study offers an example of innovative, quantitative assessment in chaplaincy training.

Drs. Ann Charlescraft, Alexander Tartaglia, and Diane Dodd-McCue presented "The Chaplain's Role in Staff Support- Assessing and Mitigating the Effects of Compassion Fatigue" at the 2010 Association of Professional Chaplains conference. This research presentation showcased a program to address and evaluate compassion fatigue, compassion satisfaction, and burnout among pediatric intensive care nurses. The presentation also provided the results of program evaluation and their potential application by staff, chaplains, and hospital administrators.

CPE sites are sought for replication of a video-based hospital orientation program used with CPE students. The orientation program is described in "Enhancing Student Engagement and Critical Thinking During Hospital Orientation for Level 1 CPE Students" (Tartaglia, et al.), which appeared in Chaplaincy Today, Spring-Summer 2009, 25(1). Please contact Dr. Alexander Tartaglia (aftartag@vcu.edu) for details.

More information is also available on the VCU Program in Patient Counseling website: www.sahp.vcu.edu/ptc.

 

4.     Neuropsychology/Neuropsychiatry of Religion --Study Update

Research Network member Kyle Johnson, Chaplain, US Army (Retired) and Visiting Professor at Jarvis Christian College, Hawkins, TX, is collaborating with Andrew Newberg, MD, Associate Professor of Radiology and Psychiatry and Director of the Center for Spirituality and the Mind at the University of Pennsylvania, on a project on the neuropsychology/neuropsychiatry of religion using Functional Magnetic Resonance Imaging (fMRI) of the brain. The research has been funded by a grant by the Effie and Wofford Cain Foundation. Participants in the study undergo brain scans while observing a series of religious and non-religious symbols, and over twenty scans have been completed. Early analysis indicates promising results, with patterns of brain activity associated with particular emotional responses to the different images representing non-religious positive stimuli, religious positive stimuli, non-religious negative stimuli, religious negative stimuli. Data collection should be completed later this year. For more information about this project, and about Chaplain Johnson's related work on Neuropastoral Care and Counseling, e-mail kdjohnson@suddenlink.net.

 

5.     New and Proposed Sections of the Network Website

Two additional sections to our website were proposed at the annual Network meeting on April 23, 2010. The first, a collection of resources for supervisors on Incorporating Research into CPE programs, has already been added. The goal here is both to centralize information and to encourage supervisors who have developed resources to share them. To post new resources, contact the Network Convener at john.ehman@uphs.upenn.edu.

A second proposed section would provide a space for students to publish research projects, especially as an intermediary step as they develop their CPE projects for academic journal publication. All papers would be approved for this online posting by the students' supervisors, and each supervisors' names would be listed the students' to indicate the approval. The thought expressed at the Network meeting was that the supervisors' approvals would constitute a sufficient quality control process. This section of the website will be added once papers begin to be submitted to the Convener.

 

6.     Convener's Report of the Spring 2010 Network Meeting, Kansas City, MO

The annual Network meeting was held on Friday, April 23, 2010 at 4:30 PM in the Marriott Downtown Hotel in Kansas City, MO, as part of the ACPE's national conference. Basic business was conducted, including approval of financial transactions. The majority of the time was spent discussing issues of research in the ACPE and members' individual projects and interests.

  • Steve Overall (St. Luke's, Kansas City) introduced guest Lucy Hood, PhD, who works with the St. Luke's CPE program in guiding students through their research projects. They talked about the process of working with the students on research, setting a planning-to-completion project schedule, and managing the fact that students' research skills tended to vary greatly. Chaplain Overall brought a number of past student project reports as illustrations of this work.
  • Paul Derrickson (Hershey Medical Center, Hershey, PA), whose conference workshop, "Getting to the Heart of Pastoral Care, Spirituality, Research and Education: The Spiritual Pathways Project" (with Angie Van Hise) immediately preceded the Network's meeting, talked about his own program's use of specialty research projects with students and noted a new article in the Journal of Health Care Chaplaincy (16:3-12, 2010): Derrickson, P. & Van Hise, A., "Curriculum for a Spiritual Pathway Project: Integrating Research Methodology into Pastoral Care Training." He also discussed a chaplaincy-is-changing approach that emphasizes students' skills and knowledge bases.
  • In relation to the issue of research into pastoral skills, Gordon Hilsman (St. Joseph Medical Center, Tacoma, WA) talked about his continuing work with the Spiritual Skills Survey, and the plan to assess students at the beginning and end of a CPE unit. (Chaplain Hilsman's research on Spiritual Patient Needs, Chaplain Functions, and Outcomes for Study and 21 specific categories of patients' needs, expressed in patients' own words was originally reported at the Honolulu meeting and noted in our Winter 2006 Newsletter.)
  • Shannon Borchert (Wesley Medical Center, Wichita, KS), Margot Hover (Barnes-Jewish Community-Based CPE, St. Louis, MO), and Sally Campbell (St. Luke's Hospital, Bethlehem, PA) all addressed the integration of research into their CPE curricula. Chaplains Campbell and Hover commented specifically on their use of our Network website as a resource (e.g., the Articles-of-the-Month).
  • Jackson Kytle (HealthCare Chaplaincy, New York, NY) reported a number of new research initiatives at the HealthCare Chaplaincy, including a prospective study of types of prayer and their effect for pre-surgery patients, a longitudinal study of dialysis patients, and an analysis of extensive data from Dartmouth Atlas and the American Hospitalization Association on ICU death that shows promise in connecting palliative care, hospice, and chaplaincy. For more on research activity at the HealthCare Chaplaincy, see the Current Research Topics section of their website (www.healthcarechaplaincy.org). Dr. Kytle also noted the potential of the HealthCare Chaplaincy to help newer researchers expand their own research education and understanding of grant application processes.
  • Ralph Ciampa (Hospital of the University of Pennsylvania, Philadelphia, PA) talked about his department's annual Spirituality Research Symposium, not in it its 13th year, and the ongoing use of a Spirituality Research & Literature Seminar in the CPE Residency program.
  • Among other topics at the meeting: the question of what constitutes an outcome for chaplains' patient care (Chaplain Overall and Dr. Hood), the question of metrics for a department "scorecard" (Chaplain Campbell), the idea of a spiritual "prescription" exercise (Walter Balk, Bronson Methodist Hospital, Kalamazoo, MI), research into connections between trauma and spirituality (Chaplain Borchert).
  • The group resolved to investigate more opportunities to provide research workshops at conferences conference and (as noted in §5, above) to expand our website to include resources for supervisors to incorporate research into their programs (--see the new section: Incorporating Research into CPE). In addition, the group supported the idea of a new section of the site by which students would be able to publish online their research project papers.

 

7.     Research from 2009 Not Previously Noted on the Research Network Website

There is so much spirituality & health research published each year [--for an extensive and general bibliography, see www.uphs.upenn.edu/pastoral/resed/bibindex.html] that many intriguing articles go unnoted in our Article-of-the-Month features or Newsletters items. Below are merely twenty additional ones from 2009 that this reader believes warrant attention by the Research Network.  --JE

Anema, C., Johnson, M., Zeller, J. M., Fogg, L. and Zetterlund, J. [Purdue University Calumet, South Holland, IL; tccnurse@aol.com]. "Spiritual well-being in individuals with fibromyalgia syndrome: relationships with symptom pattern variability, uncertainty, and psychosocial adaptation." Research & Theory for Nursing Practice 23, no. 1 (2009): 8-22. [This study of 58 individuals with fibromyalgia syndrome (FMS) found positive relationships between symptom pattern variability and uncertainty, and between uncertainty and poor psychosocial adaptation…. (From the abstract:) ….spiritual well-being moderated the relationship between uncertainty and psychosocial adaptation. A positive sense of well-being aided adaptation to symptoms and uncertainties of FMS. Spiritual well-being had a greater effect on the relationship between symptom pattern variability and uncertainty than expected.]

Beardsley, C. [Chelsea and Westminster Hospital NHS Foundation Trust, London; Christina.Beardsley@chelwest.nhs.uk]. "'In need of further tuning': using a US patient satisfaction with chaplaincy instrument in a UK multi-faith setting, including the bereaved." Clinical Medicine 9, no. 1 (February 2009): 53-58. [(Abstract:) Healthcare chaplaincy research seems further advanced in the USA. Here a US patient satisfaction with chaplaincy instrument (PSI-C-R) was used in a London NHS foundation hospital with a multi-faith chaplaincy team and population. A version of the instrument was also generated for the bereaved. PSI-C-R had not been subjected to test-retest to confirm its reliability so this was done at the pilot stage. It proved only partly reliable, but in three separate surveys a cluster of highly rated factors emerged, as in earlier studies: chaplains' prayer, competence, listening skills and spiritual sensitivity. Low-rated factors and qualitative data highlighted areas for improvement. Disappointing response rates arose from patient acuity, ethical concerns about standard follow-up protocols, and the Western Christian origins of the instrument which requires further revision for multi-faith settings, or the design of new instruments. (The items from the two instruments used here are given in tables on p. 58.)]

Bormann, J., Warren, K. A., Regalbuto, L., Glaser, D., Kelly, A., Schnack, J. and Hinton, L. [Veterans Affairs San Diego Healthcare System, San Diego, CA; jill.bormann@va.gov]. "A spiritually based caregiver intervention with telephone delivery for family caregivers of veterans with dementia." Family & Community Health 32, no. 4 (October-December 2009): 345-353. [(Abstract:) Caring for veterans with dementia is burdensome for family caregivers. This exploratory study tested the efficacy of an innovative, spiritually based mantram caregiver intervention delivered using teleconference calls. A prospective, within-subjects, mixed-methods, and 3-time repeated-measures design with 36-week follow-up telephone interviews was conducted. Sixteen caregivers (94% women, 94% Whites with mean age 69.2 years, SD = 10.35 years) completed the intervention. Significant effects for time and linear terms were found for decreasing caregiver burden, perceived stress, depression, and rumination and for increasing quality of life enjoyment and satisfaction, all with large effect sizes. Findings suggest that teleconference delivery of a spiritually based caregiver intervention is feasible.]

Bowman, E. S., Beitman, J. A., Palesh, O., Perez, J. E. and Koopman, C. [Department of Neurology, Indiana University, Indianapolis; ebowman@iupui.edu]. "The Cancer and Deity Questionnaire: a new religion and cancer measure." Journal of Psychosocial Oncology 27, no. 4 (2009): 435-453. [This test of the Cancer and Deity Questionnaire (CDQ), which assesses perceived relations with God after a cancer diagnosis, was carried out on a predominantly Christian sample of adults with recent cancer diagnoses. The 12-item measure (printed on pp. 452-453) was developed out of object relations theory, and assesses benevolent and abandoning God representations. (From the abstract:) Internal consistency was excellent for the Benevolence scale (alpha = .97) and good for the Abandonment scale (alpha = .80). Moderate correlations with the Spiritual Well-Being Scale support divergent validity. Correlations between CDQ scales and the Styles of Religious Coping scales support convergent validity. The CDQ is brief, easily scored, practical for psycho-oncology research, and adaptable for use with other illnesses.]

Cadge, W. and Ecklund, E. H. [Department of Sociology, Brandeis University, Waltham, MA; wcadge@brandeis.edu]."Prayers in the clinic: how pediatric physicians respond." Southern Medical Journal 102, no. 12 (December 2009): 1218-1221. [This study used in-depth interviews with 30 academic pediatricians and pediatric oncologists at top US hospitals. (From the abstract:) In close to 100% of cases when the subject of prayer came up in clinical contexts, it was patients and families who raised it. Patients and families mostly talked about prayer in response to a seriously ill or dying child. When it was raised, pediatric physicians responded to prayer by participating; accommodating but not participating; reframing; and directing families to other resources.]

Chida, Y., Steptoe, A. and Powell, L. H. [Psychobiology Group, Department of Epidemiology and Public Health, University College London, UK; y.chida@ucl.ac.uk]. "Religiosity/spirituality and mortality. A systematic quantitative review." Psychotherapy & Psychosomatics 78, no. 2 (2009): 81-90. [This latest meta-analysis of published studies on religiosity/spirituality and mortality assesses 69 studies (28 articles) examining the connection in an initially healthy population, and 22 studies (11 articles) examining the connection in diseased populations. (From the abstract:) The results…showed that religiosity/spirituality was associated with reduced mortality in healthy population studies (combined hazard ratio = 0.82, 95% CI = 0.76-0.87, p <0.001), but not in diseased population studies (combined hazard ratio = 0.98, 95% CI = 0.94-1.01, p = 0.19). Notably, the protective effect of religiosity/spirituality in the initially healthy population studies was independent of behavioral factors (smoking, drinking, exercising, and socioeconomic status), negative affect, and social support. We divided studies according to the aspects of religiosity/spirituality measure examined, and found that organizational activity (e.g. church attendance) was associated with greater survival in healthy population studies. Multi-dimensional aspects were related to survival in both the healthy and diseased populations. Religiosity/spirituality was negatively associated with cardiovascular mortality in healthy population studies. CONCLUSIONS: The current review suggests that religiosity/spirituality has a favorable effect on survival, although the presence of publication biases indicates that results should be interpreted with caution.]

Cotton, S., Grossoehme, D., Rosenthal, S. L., McGrady, M. E., Roberts, Y. H., Hines, J., Yi, M. S. and Tsevat, J. [Department of Family Medicine, University of Cincinnati College of Medicine, Cincinnati, OH; sian.cotton@uc.edu]. "Religious/Spiritual coping in adolescents with sickle cell disease: a pilot study." Journal of Pediatric Hematology/Oncology 31, no. 5 (May 2009): 313-318. [(From the abstract:) Religious/spiritual (R/S) coping has been associated with health outcomes in chronically ill adults; however, little is known about how adolescents use R/S to cope with a chronic illness such as sickle cell disease (SCD). Using a mixed method approach (quantitative surveys and qualitative interviews), we examined R/S coping, spirituality, and health-related quality of life in 48 adolescents with SCD and 42 parents of adolescents with SCD. Adolescents reported high rates of religious attendance and belief in God, prayed often, and had high levels of spirituality (eg, finding meaning/peace in their lives and deriving comfort from faith). Thirty-five percent of adolescents reported praying once or more a day for symptom management. The most common positive R/S coping strategies used by adolescents were: "Asked forgiveness for my sins" (73% of surveys) and "Sought God's love and care" (73% of surveys).]

Fitchett, G. and Risk, J. L. [Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, IL; george_fitchett@rush.edu]. "Screening for spiritual struggle." Journal of Pastoral Care & Counseling 63, nos. 1-2 (Spring-Summer 2009): 4-1-12 (online journal). [(Abstract:) A growing body of research documents the harmful effects of religious or spiritual struggle among patients with a wide variety of diagnoses. We developed a brief screening protocol for use in identifying patients who may be experiencing religious/spiritual struggle, as well as patients who would like a visit from a chaplain. We describe the results of a pilot study in which non-chaplain healthcare colleagues administered the screening protocol to patients admitted to an acute medical rehabilitation unit. The protocol identified 7% of the patients as possibly experiencing religious/spiritual struggle. Follow up spiritual assessments by the chaplain confirmed religious/spiritual struggle in all but one of these patients and also identified additional cases of religious/spiritual struggled not identified by the protocol. In addition to areas for future research, the authors describe how using a protocol to screen patients for religious/spiritual can make important contributions to spiritual care. ]

Flannelly, K. J., Oettinger, M., Galek, K., Braun-Storck, A. and Kreger, R. [HealthCare Chaplaincy, 307 East 60th Street, New York, NY; Kflannelly@healthcarechaplaincy.org]. "The correlates of chaplains' effectiveness in meeting the spiritual/religious and emotional needs of patients." Journal of Pastoral Care & Counseling 63, nos. 1-2 (Spring-Summer 2009): 9-1-15 [online journal]. [(Abstract:) The study was designed to assess the degree to which two sets of measures about chaplains' visits with patients predicted patients' perceptions that their spiritual/religious needs and their emotional needs were met by the chaplain. The first set consisted of seven items about the chaplain's demeanor during the visit. The second set measured patient satisfaction with seven aspects of the chaplain's care, including specific interventions. Overall, the latter items were more highly correlated with, and were better predictors of patients' perceptions that the chaplain met both their spiritual/religious needs and their emotional needs than were the demeanor items. The findings indicate the usefulness of measuring the effectiveness of specific chaplain interventions. The authors discuss that effectiveness measures may be more useful that patient satisfaction measures for assessing pastoral care.]

Galek, K., Silton, N. R., Vanderwerker, L. C., Handzo, G. F., Porter, M., Montonye, M. G. and Fleenor, D. W. [Spears Research Institute, Healthcare Chaplaincy, New York, NY; kgalek@healthcarechaplaincy.org]. "To pray or not to pray: considering gender and religious concordance in praying with the ill." Journal of Health Care Chaplaincy 16, no. 1 (January 2009): 42-52. [(Abstract:) Analysis of Covariance was conducted on quantitative data collected by chaplains from January 2005 to December 2008. Data from 82 Catholic, Jewish, and Protestant chaplains, consisting of 53 CPE students and 29 professional chaplains were used in this study. Overall, chaplains exhibited a statistically significant higher rate of prayer with patients from their own religion (religious concordance) than they did with patients of different religions (religious discordance). There was also an interaction of chaplain religion and religious concordance wherein Protestant chaplains were 50% more likely to pray with Protestant patients than with patients of other religions, and Catholic chaplains were 20% more likely to pray with Catholic patients than with other patients. Chaplains were also significantly more likely to pray with patients of their own gender (gender concordance) than with patients of the other gender (gender discordance).]

Gall, T. L., Kristjansson, E., Charbonneau, C. and Florack, P. [Saint Paul University, Ottawa, ON, Canada; tgall@ustpaul.ca]. "A longitudinal study on the role of spirituality in response to the diagnosis and treatment of breast cancer." Journal of Behavioral Medicine 32, no. 2 (April 2009): 174-186. [The findings of this study of 93 women diagnosed with breast cancer suggest (from the abstract:) that women who were less spiritually/religiously involved prior to the onset of breast cancer and who attempt to mobilize these resources under the stress of diagnosis may experience a negative process of spiritual struggle and doubt that, in turn, has implications for their long-term adjustment.]

Ironson, G. and Kremer, H. [Department of Psychology, University of Miami, Coral Gables, FL; GIronson@aol.com]. "Spiritual transformation, psychological well-being, health, and survival in people with HIV." International Journal of Psychiatry in Medicine 39, no. 3 (2009): 263-281. [(Abstract:) OBJECTIVES: Although Spiritual Transformation (ST) occurs in a sizable proportion of people with HIV (about 39%), there is little research on the potential benefits of ST with respect to psychological well-being, health, and survival in this population. Our study attempts to fill this gap. METHOD: Using a mixed method approach, we related interviews of 147 people with HIV (identifying the presence/absence of ST) to questionnaires measuring demographics, medical history, treatment adherence, physical symptoms, and psychological well-being (i.e., stress, coping, life attitude, and spirituality), and assessments of CD4-counts and viral load and survival 3 to 5 years later. RESULTS: At comparable times since HIV-diagnosis and antiretroviral medications prescribed, the presence of ST was significantly associated with better treatment success (undetectable viral loads, higher CD4 counts), better medication adherence, fewer symptoms, less distress, more positive coping, different life attitudes (i.e., existential transcendence, meaning/purpose in life, optimism, death acceptance), more spiritual practices, and increased spirituality. ST was also associated with substance-use recovery and with being African American. Survival up to 5 years was 5.35 times more likely among participants with ST (p(f) = .044). According to a Cox-regression adjusted for baseline CD4-counts, age, race-ethnicity, gender, education, years since HIV-diagnosis, and a history of substance-use problems, ST still reduced the risk of death (HR = 0.07, 95% CI = 0.01-0.53, p = .010). CONCLUSIONS: ST has associated benefits for psychological well-being, health, and survival. (See also Kremer & Ironson, "Everything changed: spiritual transformation in people with HIV," on pp. 243-262 of the same issue of the journal.)]

Johnstone, B. and Yoon, D. P. [University of Missouri-Columbia Center on Religion and the Professions, Columbia, MO; johnstoneg@health.missouri.edu]. "Relationships between the Brief Multidimensional Measure of Religiousness/Spirituality and health outcomes for a heterogeneous rehabilitation population." Rehabilitation Psychology 54, no. 4 (November 2009): 422-431. [(Abstract:) PURPOSE: To determine relationships between the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS; i.e., positive/negative spirituality, forgiveness, religious practices, positive/negative congregational support) and physical and mental health (Medical Outcomes Scale-Short Form 36; SF-36) for individuals with chronic disabilities. RESEARCH METHOD: A cross-sectional analysis of 118 individuals evaluated in outpatient settings, including 61 with traumatic brain injury (TBI), 32 with cerebral vascular accidents (CVA), and 25 with spinal cord injury (SCI). RESULTS: Three of 6 BMMRS factor scores (i.e., positive spiritual experience, forgiveness, negative spiritual experience) were significantly correlated with the SF-36 General Health Perception (GHP) scale, and only 1 of 6 BMMRS factor scores (i.e., negative spiritual experience) was significantly and negatively correlated with the SF-36 General Mental Health (GMH) scale. BMMRS scales did not significantly predict either physical or mental health in hierarchical multiple regressions. CONCLUSIONS: Positive spiritual experiences and willingness to forgive are related to better physical health, while negative spiritual experiences are related to worse physical and mental health for individuals with chronic disabilities. Future research using the BMMRS will benefit from using a 6-factor model that evaluates positive/negative spiritual experiences, religious practices, and positive/negative congregational support. Interventions to accentuate positive spiritual beliefs (e.g., forgiveness protocols, etc.) and reduce negative spiritual beliefs for individuals with chronic disabilities are suggested.]

Kreitzer, M. J., Gross, C. R., Waleekhachonloet, O. A., Reilly-Spong, M. and Byrd, M. [Center for Spirituality and Healing, School of Nursing, University of Minnesota, Minneapolis; kreit003@umn.edu]."The Brief Serenity Scale: a psychometric analysis of a measure of spirituality and well-being. " Journal of Holistic Nursing 27, no. 1 (March 2009): 7-16. Comment on pp. 17-18. [(Abstract:) PURPOSE: This article describes a factor analysis of a 22-item version of the Serenity Scale, a tool that measures spirituality and well-being. METHOD: A sample of 87 participants, enrolled in a National Institutes of Health-funded clinical trial examining the impact of mindfulness-based stress reduction on symptom management post-solid organ transplantation, completed the abbreviated instrument. FINDINGS: Exploratory factor analysis yielded three subscales: acceptance, inner haven, and trust. The Serenity Scale was positively associated with positive affect and mindful awareness and inversely related to negative affect, anxiety, depression, health distress and transplant-related stress. CONCLUSIONS: Serenity, a dimension of spirituality that is secular and distinct from religious orientation or religiosity, shows promise as a tool that could be used to measure outcomes of nursing interventions that improve health and well-being. IMPLICATIONS: Spirituality is recognized as being an essential component of holistic nursing practice. As nurses expand their use of spiritual interventions, it is important to document outcomes related to nursing care. The Serenity Scale appears to capture a dimension of spirituality, a state of acceptance, inner haven and trust that is distinct from other spirituality instruments.]

Nowatzki, N. R. and Kalischuk, R. G. [Department of Sociology, University of Manitoba, Winnipeg, Canada; nowatzkn@cc.umanitoba.ca]. "Post-death encounters: grieving, mourning, and healing." Omega - Journal of Death & Dying 59, no. 2 (2009): 91-111. [(Abstract:) Historical accounts and previous research have shown that bereaved individuals often report seeing, hearing, or feeling the presence of the deceased. We examined such encounters in the context of the grieving, mourning, and healing processes. Semi-structured, in-depth interviews were conducted with 23 individuals who reported a post-death encounter following the death of a loved one. Phenomenological analysis showed that participants went through an interpretive process in which they attempted to make sense of their experiences. The encounters profoundly affected the participants' beliefs in an afterlife and attitudes toward life and death, and had a significant impact on their grief. Finally, post-death encounters had a healing effect on the participants by contributing to a sense of connectedness with the deceased. We conclude that health care professionals and counselors should be educated about post-death encounters so that the bereaved can share their experiences in a supportive and understanding atmosphere. ]

VanderCreek, L. and Mottram, K. "The religious life during suicide bereavement: a description." Death Studies 33, no. 8 (September 2009): 741-761. [(Abstract:) This exploratory study gathered narratives from 10 female suicide survivors, exploring 3 dimensions of their religious life during bereavement: (a) the function of the survivor's personal religion; (b) the function of religious support from family and friends; and (c) the function of established religious communities. Ten themes emerged from the narratives: afterlife destiny of the loved one, a more spiritual perspective, the impact on religious beliefs, support from family and friends, survivors' contribution to emotionally distant relationships, long- term and in-depth spiritual support, religious support from congregants, the ministry of clergy, the funeral service, and the return to public worship services. The participants believed that religion played an important role in their bereavement process. The results suggest future research questions, including: (a) what is the perceived role of God in the suicide and the bereavement; (b) what is the relationship between the survivor's participation in a religious community and the care received from that community; and (c) what postvention do survivors wish from clergy?]

Vollman, M. W., LaMontagne, L. L. and Wallston, K. A. [Vanderbilt University School of Nursing, Nashville, TN; michael.vollman@vanderbilt.edu]. "Existential well-being predicts perceived control in adults with heart failure." Nursing Research 22, no. 3 (August 2009): 198-203. [(Abstract:) This study examined the relationship between spiritual well-being (SWB) and perceived control (PC) in adult patients with heart failure (HF). The sample included 75 adults ranging in age from 27 to 82 years. Participants verbally completed study questionnaires in a clinic room selected for privacy. Multiple linear regression results indicated that increased existential spiritual well-being (a subscale of SWB) predicted increased PC. Thus, patients with HF who adjust to personal changes and who also connect with others may develop meaning and purpose in life and may perceive increased control over their heart disease. ]

Winter, L., Dennis, M. P. and Parker, B. [Center for Applied Research on Aging and Health, Thomas Jefferson University, Philadelphia, PA; Laraine.Winter@Jefferson.edu]. "Preferences for life-prolonging medical treatments and deference to the will of God." Journal of Religion & Health 48, no. 4 (December 2009): 418-430. [(Abstract:) We defined and measured a dimension of religiosity frequently invoked in end-of-life (EOL) research-deference to God's Will (GW)-and examined its relationship to preferences for life-prolonging treatments. In a 35-min telephone interview, 304 older men and women (60+) were administered the 5-item GW scale, sociodemographic questions, three attitude items regarding length of life, and measures of two health indices, depression, and life-prolonging treatment preferences. The GW scale demonstrated internal consistency (Cronbach's alpha = .94) and predictive and discriminant validity. Higher scores indicative of greater deference to GW were associated with stronger life-prolonging treatment preferences in poor-prognosis scenarios. Implications for the role of religiosity in medical decision-making are discussed.]

Yanez, B., Edmondson, D., Stanton, A. L., Park, C. L., Kwan, L., Ganz, P. A. and Blank, T. O. [Department of Psychology, University of California, Los Angeles]. "Facets of spirituality as predictors of adjustment to cancer: relative contributions of having faith and finding meaning." Journal of Consulting & Clinical Psychology 77, no. 4 (August 2009): 730-741. [(Abstract:) Spirituality is a multidimensional construct, and little is known about how its distinct dimensions jointly affect well-being. In longitudinal studies (Study 1, n = 418 breast cancer patients; Study 2, n = 165 cancer survivors), the authors examined 2 components of spiritual well-being (i.e., meaning/peace and faith) and their interaction, as well as change scores on those variables, as predictors of psychological adjustment. In Study 1, higher baseline meaning/peace, as well as an increase in meaning/peace over 6 months, predicted a decline in depressive symptoms and an increase in vitality across 12 months in breast cancer patients. Baseline faith predicted an increase in perceived cancer-related growth. Study 2 revealed that an increase in meaning/peace was related to improved mental health and lower cancer- related distress. An increase in faith was related to increased cancer-related growth. Both studies revealed significant interactions between meaning/peace and faith in predicting adjustment. Findings suggest that the ability to find meaning and peace in life is the more influential contributor to favorable adjustment during cancer survivorship, although faith appears to be uniquely related to perceived cancer-related growth.]

Youngster, I., Berkovitch, M., Kozer, E., Lazarovitch, Z., Berkovitch, S. and Goldman, M. [Assaf Harofeh Medical Center, Zerifin, Israel, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Israel; ilanyoungster@yahoo.com]. " Can religious icons be vectors of infectious diseases in hospital settings?" American Journal of Infection Control 37, no. 10 (December 2009): 861-863. [(Abstract:) According to Jewish tradition, Mezuzahs should be affixed on all doorposts leading to communal places. We evaluated the bacterial pathogenic load on the Mezuzah covers in our hospital. Mezuzahs were sampled in all hospital departments, and cultures were carried out. Serving as a control group, door handles belonging to the same departments were tested as well. Most samples harbored potential pathogens. Few cultures were positive in the control group, demonstrating that regular disinfection is carried out, but apparently religious artifacts are overlooked.]

 


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