Summer 2016 Newsletter
Volume 14, Number 3
Published July 10, 2016
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-Spring, and Summer.
1. Update on Transforming Chaplaincy
2. "Moving Together, Moving Ahead" --Thoughts on the Importance of Research for the ACPE by President Carlos R. Bell
3. VCU Residents'/Master of Science Students' Research Day: A Second Year Marks a Tradition! --by Diane Dodd-McCue
4. Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, at Indiana University Health
5. Center for Spirituality and Health, at Mount Sinai (New York)
6. Scoping Reviews
7. Notable Articles from 2015 Not Previously Cited on the Research Network Website
1. Update on Transforming Chaplaincy
The Transforming Chaplaincy initiative to promote research literacy for improved patient outcomes has announced the first cohort of Fellowships and CPE Grants. The list of 8 fellows and 23 grants (involving 38 ACPE centers) is available from the program website. At the national ACPE conference in Denver, CO (May 18-21, 2016) a special dinner meeting was convened on May 19th for participants and inquirers, and presentations of three of the planned grant projects -- from the Gundersen Health System in LaCrosse, WI; the UCSF Medical Center and UCSF Benioff Children’s Hospital in San Francisco, CA; and the Iliff School of Theology in Denver, CO -- offered a picture of the range of proposals. (The three PowerPoint presentations, along with other proposal materials, are available online via Model Grant Applications to the CPE Curriculum Development Grant Program.) The creative interest of the 40+ who attended spoke well of the future of research in the ACPE. Applications for a second cohort of fellows and round of grants will open in October 2016 for selection in 2017. On July 27-29, 2016, a Kickoff Conference for the first cohort of fellows will be held in Chicago, IL, to orient recipients to the program, research, and graduate-level studies. For the latest news, go to www.researchliteratechaplaincy.org.
2. "Moving Together, Moving Ahead" --Thoughts on the Importance of Research for the ACPE by President Carlos R. Bell
[The following appeared in the May issue of the ACPE News, just ahead of the national conference in Denver, May 18-21, 2016. This is a slightly expanded version of what ACPE President Carlos R. Bell wrote for our Research Network flyer distributed at the conference. The Network thanks Dr. Bell for his support.]
On behalf of the Association for Clinical Pastoral Education (ACPE), I want to congratulate the ACPE Research Network for bringing to the forefront the importance of research. Research is essential to the future of the organization and professional practice. The mission statement of the ACPE Research Network: "The ACPE Research Network seeks to foster connections among members of the Association for Clinical Pastoral Education interested in research, encourage original research, and raise awareness about published research (e.g., in the health care literature and the education literature) related to spirituality, pastoral care, and Clinical Pastoral Education."
In their book Spiritual Care in Practice, George Fitchett, PhD, ACPE Supervisor, and Steve Nolan, PhD, Palliative Care Chaplain, wrote, "There is growing recognition among chaplains around the world that we need to be a research-informed profession, both in order to examine and improve the care we provide and to help us describe the benefits of our care to our healthcare colleagues and the people responsible for commissioning our care." The ripple effect from research informed spiritual care is immeasurable. Its impact extends into individual lives, families, medical staff, administrators, and the culture of an institution in numerous ways.
Research documents and tells the narrative of spiritual care.
Some institutional administrators consider spiritual care to be an optional add-on to the core business of healthcare. If spiritual care and pastoral education programs wish to be considered on a par with other "essential" disciplines, then the professions that we represent need to establish a firm foundation of evidence based practices. Research into the efficacy of spiritual care and spiritual care education is currently building that foundation. Spiritual care and spiritual care education also has a potential wide-reaching impact on ACPE's commitment to develop innovative models of care, use advanced technology, and conduct game-changing research. The need for chaplains to be current in research is critical at this juncture in ACPE's history.
Research is one of the key aspects of the ACPE Organizational Design Work Group. At the ACPE annual conference in May, consultants Glenn Tecker and Donna Dunn, of Tecker International, will facilitate a hands-on membership input process to guide the shaping of our future. The annual conference will be a collaborative effort for in-depth conversations regarding the future of ACPE.
We have much to be proud of and are positioned to continue our role as the premier clinical pastoral education movement. Research will help us to "Move Together, Move Ahead."
3. VCU Residents'/Master of Science Students' Research Day: A Second Year Marks a Tradition! --by Diane Dodd-McCue
Residents and Master of Science students in Virginia Commonwealth University's Department of Patient Counseling participated in the department's second annual Research Day on April 7, 2016, which was attended by faculty, interns, administrators, and hospital clinicians. The event was an opportunity to present and celebrate the completion of a quality improvement project in conjunction with the program's mandatory research courses. This year's project, "The Interprofessional Collaboration and Integration of VCU Health Units: An Exploratory Study," involved survey data collection and development of abstracts, posters, and presentations of unit-specific findings to relevant stakeholders, along with plans for future dissemination of findings. The project focused on six unique hospital units to which the residents/students were assigned.
Integration and interprofessional collaboration served as the content focus for this year's project, complimenting prior student projects on unit culture. As with prior years' research projects, this effort reflects the collaboration of students, faculty, administrators, and clinicians. A compilation of the students' work was made available electronically and in hard copy for the Department of Patient Counseling's faculty, residents, and students as a summary of each unit and to identify ways to strengthen and nurture integration of chaplains into care teams. Additionally, residents have or will be presenting their findings and posters in the hospital units represented in this project.
A summary was also presented at the Fourth Annual Emswiller Interprofessional Symposium --a University event focusing on inter-professional education and practice -- in February 2016, as a student project involving application of research methods. See the summary poster as a PowerPoint slide or PDF.
Residents and Master of Science students participating in the Research Summit included
(L-R): Emily Hunter Rhodes, Daniel Kim, Fady Fous, Dexter Honora, Amanda Hayes Bowman.
Not pictured: Carol Chaffin.
The project is a capstone assignment of research courses developed and taught by Diane Dodd-McCue, DBA, Associate Professor.
For additional information, contact Dr. Dodd-McCue at firstname.lastname@example.org.
- RESEARCH BASICS FOR HOSPITAL CHAPLAINS. Semester course; 1 lecture hour. 1 credit. provides an overview of research basics, research methods terminology, and study critique within the context of hospital chaplaincy. Emphasizes the methodological issues in health services research that involve hospital chaplains.
- EVIDENCE-BASED INQUIRY FOR HOSPITAL CHAPLAINS. Semester course; 1 lecture hour. 1 credit. Prerequisite: Research Basics for Hospital Chaplains. Provides an overview of data collection, data quality and data usage within the context of hospital chaplaincy. Emphasizes an understanding of the use of data by health services administrators in operational and strategic decisions and for performance improvement.
- DEVELOPING AND PRESENTING CHAPLAINCY RESEARCH. Semester course; 1 lecture hour. 1 credit. Prerequisite: Research Basics for Hospital Chaplains. Provides an overview of how to analyze and present evidence-based project findings and recommendations within a hospital or academic environment. Emphasizes understanding different objectives and dissemination routes for evidence-based chaplaincy projects as well as demonstrating an understanding of dissemination of evidence-based project results to relevant audiences.
4. Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, at Indiana University Health
The Daniel F. Evans Center for Spiritual and Religious Values in Healthcare, at Indiana University Health (http://evanscenterindiana.org), was founded in 1996 to "promote and provide resources for initiatives, programs and research that integrate the values of compassion, whole person care, ethical practice and spiritual care services into all patient care, community wellness and staff development activities" [--see the Center’s website]. Among its projects has been "A Chaplain Intervention to Reduce Spiritual Distress in Family Surrogate Decision Makers," seeking to develop and pilot test an intervention at Indiana University Health Hospitals; and faculty members have been involved in the following recently published study [available online]:
Geros-Willfond, K. N., Ivy, S. S., Montz, K., Bohan, S. E. and Torke, A. M. "Religion and Spirituality in Surrogate Decision Making for Hospitalized Older Adults." Journal of Religion and Health 55, no. 3 (June 2016): 765-777. [(Abstract:) We conducted semi-structured interviews with 46 surrogate decision makers for hospitalized older adults to characterize the role of spirituality and religion in decision making. Three themes emerged: (1) religion as a guide to decision making, (2) control, and (3) faith, death and dying. For religious surrogates, religion played a central role in end of life decisions. There was variability regarding whether God or humans were perceived to be in control; however, beliefs about control led to varying perspectives on acceptance of comfort-focused treatment. We conclude that clinicians should attend to religious considerations due to their impact on decision making.]
The Center's website also conveniently lists a number of links to other centers and programs.
Steven S. Ivy, Senior Vice President for Values, Ethics, Social Responsibility, and Pastoral Services at Indiana University Health, says of the Center: "’Research’ related to religion and medicine, spirituality and health, is as old as ancient shamans and priests. Rabbis, priests, pastors, imams, and theologians have included their observations and convictions in more-or-less systematic wrings for thousands of years. The late 19th and early 20th century witnessed a new form of research through William James and other early psychologists of religion. Anton Boison's participant-observer research sparked an entire movement now evident in clinical chaplaincy and pastoral education. In the late 20th century another movement developed when physicians, particularly physician-researchers, took interest in religious and spiritual phenomena at the interface of physical and behavioral health. The Evans Center for Religious and Spiritual Values in Healthcare was created to engage both the lives of faithful religious congregants and the reality of modern medicine. We are very open to multi-site projects and programs, and thus invite conversations regarding future projects rooted in the long history of discovery at the religion, spirituality, and well-being interface." [--personal communication to the Research Network].
For more information and to explore possibilities for projects in cooperation with the Center, contact Dr. Ivy at SIvy@IUHealth.org.
5. Center for Spirituality and Health, at Mount Sinai (New York)
A new Center for Spirituality and Health, within the Icahn School of Medicine at Mount Sinai (New York, NY), was announced in the fall of 2015 as an outgrowth of the Mount Sinai Health System's Department of Spiritual Care and Education. It's purpose is to "develop clinical, educational, and research activities designed to enhance our understanding of the important role spirituality plays in the prevention of and recovery from physical and mental illnesses" [--see Mount Sinai's Medicine Matters, 12/28/15]. Inaugural Director, Deborah B. Marin, MD, Professor of Psychiatry, has said of the Center, "Our goal is to investigate how spirituality and clinical treatment align so we can provide our patients with the best care we can," and that staff, including physicians, nurses, and social workers throughout the Health System, will be trained to understand and support the potential of spirituality in improving a patient’s well-being [ibid.]. The Center has four areas of focus: research, education, clinical care, and community engagement.
The Center has now created a Facebook page (www.facebook.com/MountSinaiCSH) and a YouTube channel (http://bit.do/Mount-Sinai-Spiritual-Health) containing videos of Grand Rounds presentations. Some recent uploads:
- "Advancing Whole Person Care: Curricula Development in Spirituality and Health," with Christina Puchalski
- "Developing Evidence-Based Models for Screening for Spiritual Needs," with George Fitchett
- "QI Project to Assess and Address Barriers to Receiving Spiritual Care at Mount Sinai Hospital," with John Y. Rhee
For more information and/or to be added to the Center's email list, contact David Flexor (email@example.com), Director of Education, Center for Spirituality and Health.
6. Scoping Reviews
The term scoping review is increasingly common in the health care research literature. While it only began appearing in articles in the mid-2000s, it caught on significantly within a decade, so that its incidence in Medline-indexed publications moved from just 28 during 2010, to 97 during 2013, to 183 during 2015. Overall, the term lacks a precise definition, but it may be distinguished from the concept of a traditional systematic review by the following descriptions [--from p. 2 of Levac, D., et al., "Scoping studies: advancing the methodology," Implementation Science 5 (2010): 69 (electronic journal article designation)]:
In a recent scoping review of evidence in health care chaplaincy, Barbara Pesut and colleagues say of the term: "Scoping reviews systematically map bodies of evidence that are emerging, abstract, vast, or complex to identify sources of evidence and gaps in the literature in contrast to traditional systematic reviews that focus on evaluating established bodies of evidence [--see Pesut (below), p. 69]. It may be an especially useful approach to gaining a bearing on areas of the spiritually and health literature where a more traditionally systematic review process seems impractical, and chaplains may want to keep this in mind, with an understanding that the methodology has yet to crystalize fully. [For more, see Pham, M. T., "A scoping review of scoping reviews: advancing the approach and enhancing the consistency," Research Synthesis Methods 5 (2014): 371–385 (online journal).]
- "[a]im to map rapidly the key concepts underpinning a research area and the main sources and types of evidence available"
- "…concerned with contextualizing knowledge in terms of identifying the current state of understanding; identifying the sorts of things we know and do not know; and then setting this within policy and practice contexts"
- "[p]reliminary assessment of potential size and scope of research literature"
- "involves the synthesis and analysis of a wide range of research and non-research material to provide greater conceptual clarity about a specific topic or field of evidence"
Recent "scoping reviews" of interest for chaplains:
See especially the article by Pesut, B., et al. (above), as an important contribution to the chaplaincy literature.
Carey, L. B., Hodgson, T. J., Krikheli, L., Soh, R. Y., Armour, A. R., Singh, T. K. and Impiombato, C. G. "Moral injury, spiritual care and the role of chaplains: an exploratory scoping review of literature and resources." Journal of Religion & Health 55, no. 4 (August 2016): 1218-1245. [(Abstract:) This scoping review considered the role of chaplains with regard to 'moral injury'. Moral injury is gaining increasing notoriety. This is due to greater recognition that trauma (in its various forms) can cause much deeper inflictions and afflictions than just physiological or psychological harm, for there may also be wounds affecting the 'soul' that are far more difficult to heal-if at all. As part of a larger research program exploring moral injury, a scoping review of literature and other resources was implemented utilising Arksey and O'Malley's scoping method (Int J Soc Res Methodol 8(1):19-32, 2005) to focus upon moral injury, spirituality (including religion) and chaplaincy. Of the total number of articles and/or resources noting the term 'moral injury' in relation to spiritual/religious issues (n = 482), the results revealed 60 resources that specifically noted moral injury and chaplains (or other similar bestowed title). The majority of these resources were clearly positive about the role (or the potential role) of chaplains with regard to mental health issues and/or moral injury. The World Health Organization International Classification of Diseases: Australian Modification of Health Interventions to the International Statistical Classification of Diseases and related Health problems (10th revision, vol 3-WHO ICD-10-AM, Geneva, 2002), was utilised as a coding framework to classify and identify distinct chaplaincy roles and interventions with regard to assisting people with moral injury. Several recommendations are made concerning moral injury and chaplaincy, most particularly the need for greater research to be conducted.]
Fang, M. L., Sixsmith, J., Sinclair, S. and Horst, G. "A knowledge synthesis of culturally-and spiritually-sensitive end-of-life care: findings from a scoping review." BMC Geriatrics 16, no. 1 (2016): 107 [electronic journal article designation; 14 pp.]. [(Abstract:) BACKGROUND: Multiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool. METHODS: To explore attitudes, behaviours and patterns to utilization of EoL care by culturally and spiritually diverse groups and identify gaps in EoL care practice and delivery methods, a scoping review and thematic analysis of article content was conducted. Fourteen electronic databases and websites were searched between June-August 2014 to identify English-language peer-reviewed publications and grey literature (including reports and other online resources) published between 2004-2014. RESULTS: The search identified barriers and enablers at the systems, community and personal/family levels. Primary barriers include: cultural differences between healthcare providers; persons approaching EoL and family members; under-utilization of culturally-sensitive models designed to improve EoL care; language barriers; lack of awareness of cultural and religious diversity issues; exclusion of families in the decision-making process; personal racial and religious discrimination; and lack of culturally-tailored EoL information to facilitate decision-making. CONCLUSIONS: This review highlights that most research has focused on decision-making. There were fewer studies exploring different cultural and spiritual experiences at the EoL and interventions to improve EoL care. Interventions evaluated were largely educational in nature rather than service oriented.]
Jones, K., Simpson, G. K., Briggs, L. and Dorsett, P. "Does spirituality facilitate adjustment and resilience among individuals and families after SCI?" Disability and Rehabilitation 38, no. 10 (2016): 921-935. [(Abstract:) PURPOSE: The purpose of this scoping review was to investigate the role of spirituality in facilitating adjustment and resilience after spinal cord injury (SCI) for the individual with SCI and their family members. METHOD-DATA SOURCES: Peer reviewed journals were identified using PsychInfo, MEDLINE, CINAHL, Embase and Sociological Abstracts search engines. STUDY SELECTION: After duplicates were removed, 434 abstracts were screened applying inclusion and exclusion criteria. DATA EXTRACTION: The selected 28 studies were reviewed in detail and grouped according to methodological approach. RESULTS: Of the 28 studies relating to spirituality and related meaning-making constructs, 26 addressed the adjustment of the individual with SCI alone. Only two included family members as participants. Quantitative studies demonstrated that spirituality was positively associated with life satisfaction, quality of life, mental health and resilience. The utilisation of meaning-making and hope as coping strategies in the process of adjustment were highlighted within the qualitative studies. Clinical implications included recommendations that spirituality and meaning-making be incorporated in assessment and interventions during rehabilitation. The use of narratives and peer support was also suggested. CONCLUSIONS: Spirituality is an important factor in adjustment after SCI. Further research into the relationship between spirituality, family adjustment and resilience is needed. IMPLICATIONS FOR REHABILITATION: Higher levels of spirituality were associated with improved quality of life, life satisfaction, mental health, and resilience for individuals affected by spinal cord injury. Health professionals can enhance the role that spirituality plays in spinal rehabilitation by incorporating the spiritual beliefs of individuals and their family members into assessment and intervention. By drawing upon meaning-making tools, such as narrative therapy, incorporating peer support, and assisting clients who report a decline in spirituality, health professionals can provide additional support to individuals and their family members as they adjust to changes after spinal cord injury.]
Pesut, B., Sinclair, S., Fitchett, G., Greig, M. and Koss, S. E. "Health care chaplaincy: a scoping review of the evidence 2009-2014." Journal of Health Care Chaplaincy 22, no. 2 (Apr-Jun 2016): 67-84. [(Abstract:) There is a growing body of evidence investigating chaplaincy services. The purpose of this scoping review was to examine the empirical liter ature specific to the role of chaplaincy within health care published since 2009. Electronic searches of four databases were conducted in August 2015. After screening, 48 studies were retained and reviewed. Four themes emerged: experiences and perceptions of the health care chaplain (n = 15), chaplain practice (n = 9), emerging areas of health care chaplaincy (n = 16), and outcome studies (n = 8). Studies were diverse in topics covered, methods, national contexts, and clinical settings. The majority were descriptive in nature. Evidence continues to demonstrate a relationship between chaplains and increased patient satisfaction. Nascent areas of research include chaplain's role with diverse populations, involvement in clinical ethics, and confidence with research and evidence-based practice. Few conclusions can be drawn from the limited evidence on the outcomes of chaplain interventions.]
7. Notable Articles from 2015 Not Previously Cited on the Research Network Website
Our Network regularly highlights quite a number of articles, yet a good many are not cited in the course of a year. The following two dozen have until now not been noted but may be of special interest to chaplains. They are part of an annual annotated bibliography of Medline-indexed articles, available from the Penn Medicine Department of Pastoral Care. (The full 2015 bibliography contains abstracts or descriptions for 237 articles, chosen from the more than 1140 articles published during the year and categorized in Medline under the subject headings of "Religion and Medicine," "Religion and Psychology," "Religion," "Spirituality," and "Pastoral Care"; plus selected articles from Medline’s In-Process database that were not yet listed on the general Medline database at the time of this bibliography’s completion.)
Abu-Raiya, H., Pargament, K. I., Krause, N. and Ironson, G. [Tel Aviv University, Bowling Green State University, University of Michigan, and University of Miami]. "Robust links between religious/spiritual struggles, psychological distress, and well-being in a national sample of American adults." American Journal of Orthopsychiatry 85, no. 6 (Nov 2015): 565-575. [(Abstract:) This study is one of the first attempts to examine the relationships between religious and spiritual struggles (r/s struggles) measured comprehensively and indicators of psychological distress (i.e., depressive symptoms, generalized anxiety) and well-being (i.e., satisfaction with life, happiness) using a nationally representative sample of American adults (N = 2,208) dealing with a wide range of major life stressors. In addition, it examines the key question of whether these relationships persist after controlling for potentially confounding psychosocial/religious influences. Correlational analyses revealed that all 5 types of the r/s struggles assessed (i.e., divine, demonic, interpersonal, moral, ultimate-meaning) correlated significantly positively with both depressive symptoms and generalized anxiety, and significantly negatively with both satisfaction with life and happiness. Hierarchical regression analyses indicated that even after controlling for the effects of demographics and other potentially confounding variables (i.e., neuroticism, social isolation, religious commitment) the r/s struggle subscales added unique variance to the prediction of all 4 criterion measures. Theoretical and practical implications of the findings are offered, and the limitations of the study are discussed.]
Agli, O., Bailly, N. and Ferrand, C. [University Francois Rabelais Tours, France]. "Spirituality and religion in older adults with dementia: a systematic review." International Psychogeriatrics 27, no. 5 (May 2015): 715-725. [(Abstract:) BACKGROUND: Religious and spiritual issues are clearly important to the older adult population and may play a positive role in maintaining health and recovering from illness. This study systematically reviewed the literature examining the effects of religion and spirituality on health outcomes such as cognitive functioning, coping strategies, and quality of life in people with dementia. METHODS: First, 51 articles with defined keywords were collected from online databases. Then, using inclusion and exclusion criteria, 11 articles were selected. These were classified according to methodological quality before being analyzed one by one. RESULTS: The findings highlight the benefits of spirituality and religion on health outcomes. Three articles showed that in participants who used their spirituality or religion more, through their faith, their practices and in maintaining social interactions, their cognitive disorders tended to reduce or stabilize. In the other eight articles, use of spirituality or faith in daily life enabled people to develop coping strategies to help accept their disease, maintain their relationships, maintain hope, and find meaning in their lives, thereby improving their quality of life. CONCLUSIONS: Spirituality and religion appear to slow cognitive decline, and help people use coping strategies to deal their disease and have a better quality of life. This literature review allows us to take stock of research over the last decade on spirituality/religion and health outcomes. The benefits observed should be considered with caution and included in rigorous experimental research in the future.]
Akrawi, D., Bartrop, R., Potter, U. and Touyz, S. [University of Western Sydney, Campbelltown; Sydney Medical School-Northern, St. Leonards; Blacktown/Mt Druitt Clinical School, Blacktown Hospital, Sydney; and University of Sydney, Australia]. "Religiosity, spirituality in relation to disordered eating and body image concerns: a systematic review." Journal of Eating Disorders 3 (2015): 29 [electronic journal article designation]. [(Abstract:) OBJECTIVE: This systematic review aims to critically examine the existing literature that has reported on the links between aspects of religiosity, spirituality and disordered eating, psychopathology and body image concerns. METHOD: A systematic search of online databases (PsycINFO, Medline, Embase and Web of Science) was conducted in December 2014. A search protocol was designed to identify relevant articles that quantitatively explored the relationship between various aspects of religiosity and/or spirituality and disordered eating, psychopathology and/or body image concerns in non-clinical samples of women and men. RESULTS: Twenty-two studies were identified to have matched the inclusion criteria. Overall, the main findings to emerge were that strong and internalised religious beliefs coupled with having a secure and satisfying relationship with God were associated with lower levels of disordered eating, psychopathology and body image concern. Conversely, a superficial faith coupled with a doubtful and anxious relationship with God were associated with greater levels of disordered eating, psychopathology and body image concern. DISCUSSION: While the studies reviewed have a number of evident limitations in design and methodology, there is sufficient evidence to make this avenue of enquiry worth pursuing. It is hoped that the direction provided by this review will lead to further investigation into the protective benefits of religiosity and spirituality in the development of a clinical eating disorder. Thus a stronger evidence base can then be utilised in developing community awareness and programs which reduce the risk.]
Best, M., Aldridge, L., Butow, P., Olver, I., Price, M. and Webster, F. [University of Sydney, Australia]. "Assessment of spiritual suffering in the cancer context: a systematic literature review." Palliative & Supportive Care 13, no. 5 (Oct 2015): 1335-1361. [(Abstract:) OBJECTIVE: An important goal of cancer medicine is relief of patients' suffering. In view of the clinical challenges of identifying suffering patients, we sought to identify valid instruments for assessing the spiritual suffering of people diagnosed with cancer. METHOD: A systematic review of the literature was conducted in the Medline, Embase, the Cochrane Library, and PsycINFO databases seeking assessment instruments that measure either suffering or one of its synonyms or symptoms. The psychometric properties of the identified measures were compared. RESULTS: A total of 90 articles were identified that supplied information about 58 measures. The constructs examined were: suffering, hopelessness/demoralization, hope, meaning, spiritual well-being, quality of life where a spiritual/existential dimension was included, distress in the palliative care setting and pain, distress or struggle of a spiritual nature. The Pictorial Representation of Illness and Self Measure (PRISM) (patient completed) was the most promising measure identified for measuring the burden of suffering caused by illness due to its ease of use and the inclusion of a subjective component. SIGNIFICANCE OF RESULTS: Although the appropriateness of any measure for the assessment of spiritual suffering in cancer patients will depend on the context in which it is intended to be utilized, the PRISM is promising for measuring the burden of suffering due to illness.]
Brown, A. J., Sun, C. C., Urbauer, D., Zhukovsky, D. S., Levenback, C., Frumovitz, M., Thaker, P. H., Bodurka, D. C. and Ramondetta, L. M. [University of Texas MD Anderson Cancer Center, Houston, TX]. "Targeting those with decreased meaning and peace: a supportive care opportunity." Supportive Care in Cancer 23, no. 7 (Jul 2015): 2025-2032. [(Abstract:) PURPOSE: To evaluate if an individual's level of meaning/peace (M/P) predicts various quality of life (QOL) and mental well-being measures. To identify targets that might enhance the overall spiritual well-being and QOL of ovarian cancer patients. METHODS: Multi-site analysis of women with newly diagnosed stages II-IV ovarian, primary peritoneal, or fallopian tube cancer. Patients completed the following surveys: Functional Assessment of Chronic Illness Therapy-Ovarian (FACT-O), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HADS), Templer's Death Anxiety Scale (DAS), Herth Hope Index (HHI), and Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS). Linear regression models were created to examine the effect of M/P (FACIT-Sp) upon QOL, symptoms, and other measures of mental well-being. These models adjusted for the effect of site, race, age, stage, anaphylaxis to chemotherapy, and partner status as potential confounders. RESULTS: This study enrolled 104 patients from three separate sites. After adjusting for potential confounders, it was found that higher M/P predicted better QOL (FACT-O) (p<0.0001). Higher M/P also predicted decreased death anxiety, depression, and anxiety (p<0.005). Finally, higher M/P predicted increased hope and coping scores (p<0.0005). CONCLUSIONS: Level of M/P is associated with several important mental and physical health states. This information may allow providers to identify patients at increased risk for mental/physical distress and may facilitate early referral to targeted psychotherapy interventions focused on improving patient QOL and decreasing anxiety and depression.]
Cheng, J., Purcell, H. N., Dimitriou, S. M. and Grossoehme, D. H. [College of Medicine, Texas A&M Health Science Center, Bryan, TX]. "Testing the feasibility and acceptability of a chaplaincy intervention to improving treatment attitudes and self-efficacy of adolescents with cystic fibrosis: a pilot study." Journal of Health Care Chaplaincy 21, no. 2 (2015): 76-90. [(Abstract:) Religious factors are known to contribute to treatment adherence in different patient populations, and religious coping has been found to be particularly important to adolescents dealing with chronic diseases. Adherence to prescribed treatments slows disease progression and contributes to desirable outcomes in most patients, and, therefore, adherence-promoting interventions provided by chaplains could be beneficial to various patient populations. The current article describes a pilot study to test the feasibility of a theoretically and empirically based chaplain intervention to promote treatment adherence for adolescents with CF. Cognitive interviews were conducted 24 with adolescents with CF, and content analysis was used to identify themes, which informed revision of the intervention protocol. The authors thought that presenting the methods and results of this pilot study would be helpful for chaplains who want to conduct intervention research. The results indicated that the proposed intervention was acceptable and feasible to deliver in hard copy or an electronic platform.]
Choi, P. J., Curlin, F. A. and Cox, C. E. [Duke University Medical Center, Durham, NC]. "'The patient is dying, please call the chaplain': the activities of chaplains in one medical center's Intensive Care Units." Journal of Pain & Symptom Management 50, no. 4 (Oct 2015): 501-506. [(Abstract:) CONTEXT: Patients and families commonly experience spiritual stress during an intensive care unit (ICU) admission. Although most patients report that they want spiritual support, little is known about how these issues are addressed by hospital chaplains. OBJECTIVES: To describe the prevalence, timing, and nature of hospital chaplain encounters in ICUs. METHODS: This was a retrospective cross-sectional study of adult ICUs at an academic medical center. Measures included days from ICU admission to initial chaplain visit, days from chaplain visit to ICU death or discharge, hospital and ICU lengths of stay, severity of illness at ICU admission and chaplain visit, and chart documentation of chaplain communication with the ICU team. RESULTS: Of a total of 4169 ICU admissions over six months, 248 (5.9%) patients were seen by chaplains. Of the 246 patients who died in an ICU, 197 (80%) were seen by a chaplain. There was a median of two days from ICU admission to chaplain encounter and a median of one day from chaplain encounter to ICU discharge or death. Chaplains communicated with nurses after 141 encounters (56.9%) but with physicians after only 14 encounters (5.6%); there was no documented communication in 55 encounters (22%). CONCLUSION: In the ICUs at this tertiary medical center, chaplain visits are uncommon and generally occur just before death among ICU patients. Communication between chaplains and physicians is rare. Chaplaincy service is primarily reserved for dying patients and their family members rather than providing proactive spiritual support. These observations highlight the need to better understand challenges and barriers to optimal chaplain involvement in ICU patient care.]
Currier, J. M., Holland, J. M. and Drescher, K. D. [University of South Alabama, Psychology Department, Mobile]. "Spirituality factors in the prediction of outcomes of PTSD treatment for U.S. military veterans." Journal of Traumatic Stress 28, no. 1 (Feb 2015): 57-64. [(Abstract:) Spirituality is a multifaceted construct that might affect veterans' recovery from posttraumatic stress disorder (PTSD) in adaptive and maladaptive ways. Using a cross-lagged panel design, this study examined longitudinal associations between spirituality and PTSD symptom severity among 532 U.S. veterans in a residential treatment program for combat-related PTSD. Results indicated that spirituality factors at the start of treatment were uniquely predictive of PTSD symptom severity at discharge, when accounting for combat exposure and both synchronous and autoregressive associations between the study variables, betas = .10 to .16. Specifically, veterans who scored higher on adaptive dimensions of spirituality (daily spiritual experiences, forgiveness, spiritual practices, positive religious coping, and organizational religiousness) at intake fared significantly better in this program. In addition, possible spiritual struggles (operationalized as negative religious coping) at baseline were predictive of poorer PTSD outcomes, beta = .11. In contrast to these results, PTSD symptomatology at baseline did not predict any of the spirituality variables at posttreatment. In keeping with a spiritually integrative approach to treating combat-related PTSD, these results suggest that understanding the possible spiritual context of veterans' trauma-related concerns might add prognostic value and equip clinicians to alleviate PTSD symptomatology among those veterans who possess spiritual resources or are somehow struggling in this domain.]
Epstein-Peterson, Z. D., Sullivan, A. J., Enzinger, A. C., Trevino, K. M., Zollfrank, A. A., Balboni, M. J., VanderWeele, T. J. and Balboni, T. A. [Harvard University, Boston, MA; Dana-Farber Cancer Institute, Boston, MA; Rowan University, Glassboro, NJ; and Massachusetts General Hospital, Boston, MA]. "Examining forms of spiritual care provided in the advanced cancer setting." American Journal of Hospice and Palliative Medicine 32, no. 7 (Nov 2015): 750-757. [(Abstract:) Spiritual care (SC) is important to the care of seriously ill patients. Few studies have examined types of SC provided and their perceived impact. This study surveyed patients with advanced cancer (N = 75, response rate [RR] = 73%) and oncology nurses and physicians (N = 339, RR = 63%). Frequency and perceived impact of 8 SC types were assessed. Spiritual care is infrequently provided, with encouraging or affirming beliefs the most common type (20%). Spiritual history taking and chaplaincy referrals comprised 10% and 16%, respectively. Most patients viewed each SC type positively, and SC training predicted provision of many SC types. In conclusion, SC is infrequent, and core elements of SC-spiritual history taking and chaplaincy referrals-represent a minority of SC. Spiritual care training predicts provision of SC, indicting its importance to advancing SC in the clinical setting.]
Ernecoff, N. C., Curlin, F. A., Buddadhumaruk, P. and White, D. B. [University of Pittsburgh School of Medicine, Pittsburgh, PA; and Duke University, Durham, NC]. "Health care professionals' responses to religious or spiritual statements by surrogate decision makers during goals-of-care discussions." JAMA Internal Medicine 175, no. 10 (Oct 2015): 1662-1669. [(Abstract:) IMPORTANCE: Although many patients and their families view religion or spirituality as an important consideration near the end of life, little is known about the extent to which religious or spiritual considerations arise during goals-of-care conversations in the intensive care unit. OBJECTIVES: To determine how frequently surrogate decision makers and health care professionals discuss religious or spiritual considerations during family meetings in the intensive care unit and to characterize how health care professionals respond to such statements by surrogates. DESIGN, SETTING, AND PARTICIPANTS: A multicenter prospective cohort study was conducted between October 8, 2009, and October 24, 2012, regarding 249 goals-of-care conversations between 651 surrogate decision makers and 441 health care professionals in 13 intensive care units across the United States. Audio-recorded conversations between surrogate decision makers and health care professionals were analyzed, transcribed, and qualitatively coded. Data analysis took place from March 10, 2012, through May 24, 2014. EXPOSURES: Goals-of-care conferences. MAIN OUTCOMES AND MEASURES: Constant comparative methods to develop a framework for coding religious and spiritual statements were applied to the transcripts. Participants completed demographic questionnaires that included religious affiliation and religiosity. RESULTS: Of 457 surrogate decision makers, 355 (77.6%) endorsed religion or spirituality as fairly or very important in their life. Discussion of religious or spiritual considerations occurred in 40 of 249 conferences (16.1%). Surrogates were the first to raise religious or spiritual considerations in most cases (26 of 40). Surrogates' statements (n=59) fell into the following 5 main categories: references to their religious or spiritual beliefs, including miracles (n=34); religious practices (n=19); religious community (n=8); the notion that the physician is God's instrument to promote healing (n=4); and the interpretation that the end of life is a new beginning for their loved one (n=4). Some statements fell into more than 1 category. In response to surrogates' religious or spiritual statements, health care professionals redirected the conversation to medical considerations (n=15), offered to involve hospital spiritual care providers or the patient's own religious or spiritual community (n=14), expressed empathy (n=13), acknowledged surrogates' statements (n=11), or explained their own religious or spiritual beliefs (n=3). In only 8 conferences did health care professionals attempt to further understand surrogates' beliefs, for example, by asking questions about the patient's religion. CONCLUSIONS AND RELEVANCE: Among a cohort of surrogate decision makers with a relatively high degree of religiosity, discussion of religious or spiritual considerations occurred in fewer than 20% of goals-of-care conferences in intensive care units, and health care professionals rarely explored the patient's or family's religious or spiritual ideas.]
Feuille, M. and Pargament, K. [Bowling Green State University]. "Pain, mindfulness, and spirituality: a randomized controlled trial comparing effects of mindfulness and relaxation on pain-related outcomes in migraineurs." Journal of Health Psychology 20, no. 8 (Aug 2015): 1090-1106. [(Abstract:) In order to examine mindfulness as an intervention for pain, 107 migraineurs, predominantly college students, were randomly assigned to brief training in standardized mindfulness, spiritualized mindfulness, and simple relaxation instructions. After 2 weeks of daily practice, participants completed the cold-pressor task while practicing their assigned technique, and their experience of the task was assessed. Among the 74 study-completers, standardized mindfulness led to significantly reduced pain-related stress relative to simple relaxation, providing modest support for the utility of mindfulness in pain management. Pain-related outcomes in the spiritualized mindfulness condition were similar to those of standardized mindfulness, though spirituality did appear to enhance mindful awareness.]
Fitchett, G., Tartaglia, A., Massey, K., Jackson-Jordon, B. and Derrickson, P. E. [Rush University Medical Center, Chicago, IL; Virginia Commonwealth University, Richmond, VA; Advocate Health Care, Downers Grove, IL; and Carolinas Healthcare Northeast, Concord, NC]. "Education for professional chaplains: Should certification competencies shape curriculum?" Journal of Health Care Chaplaincy 21, no. 4 (2015): 151-164. [(Abstract:) The growing importance of professional chaplains in patient-centered care has raised questions about education for professional chaplaincy. One recommendation is that the curricula of Clinical Pastoral Education (CPE) residency programs make use of the chaplaincy certification competencies. To determine the adoption of this recommendation, we surveyed CPE supervisors from 26 recently re-accredited, stipended CPE residency programs. We found the curricula of 38% of these programs had substantive engagement with the certification competencies, 38% only introduced students to the competences, and 23% of the programs made no mention of them. The majority of the supervisors (59%) felt engagement with the competencies should be required while 15% were opposed to such a requirement. Greater engagement with chaplaincy certification competencies is one of several approaches to improvements in chaplaincy education that should be considered to ensure that chaplains have the training needed to function effectively in a complex and changing healthcare environment.]
Frazier, M., Schnell, K., Baillie, S. and Stuber, M. L. [David Geffen School of Medicine at UCLA, Los Angeles, CA]. "Chaplain rounds: a chance for medical students to reflect on spirituality in patient-centered care." Academic Psychiatry 39, no. 3 Jun 2015): 320-323. [(Abstract:) OBJECTIVE: This study assesses the perceived impact of a required half-day with a hospital chaplain for first-year medical students, using a qualitative analysis of their written reflections. METHODS: Students shadowed chaplains at the UCLA hospital with the stated goal of increasing their awareness and understanding of the spiritual aspects of health care and the role of the chaplain in patient care. Participation in the rounds and a short written reflection on their experience with the chaplain were required as part of the first-year Doctoring course. RESULTS: The qualitative analysis of reflections from 166 students using grounded theory yielded four themes: (1) the importance of spiritual care, (2) the chaplain's role in the clinical setting, (3) personal introspection, and (4) doctors and compassion. CONCLUSIONS: Going on hospital rounds with a chaplain helps medical students understand the importance of spirituality in medicine and positively influences student perceptions of chaplains and their work.
Goncalves, J. P., Lucchetti, G., Menezes, P. R. and Vallada, H. [University of Sao Paulo Medical School, Sao Paulo; and Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil]. "Religious and spiritual interventions in mental health care: a systematic review and meta-analysis of randomized controlled clinical trials." Psychological Medicine 45, no. 14 (Oct 2015): 2937-2949. [(Abstract:) BACKGROUND: Despite the extensive literature assessing associations between religiosity/spirituality and health, few studies have investigated the clinical applicability of this evidence. The purpose of this paper was to assess the impact of religious/spiritual interventions (RSI) through randomized clinical trials (RCTs). METHOD: A systematic review was performed in the following databases: PubMed, Scopus, Web of Science, PsycINFO, Cochrane Collaboration, Embase and SciELO. Through the use of a Boolean expression, articles were included if they: (i) investigated mental health outcomes; (ii) had a design consistent with RCTs. We excluded protocols involving intercessory prayer or distance healing. The study was conducted in two phases by reading: (1) title and abstracts; (2) full papers and assessing their methodological quality. Then, a meta-analysis was carried out. RESULTS: Through this method, 4751 papers were obtained, of which 23 remained included. The meta-analysis showed significant effects of RSI on anxiety general symptoms (p < 0.001) and in subgroups: meditation (p < 0.001); psychotherapy (p = 0.02); 1 month of follow-up (p < 0.001); and comparison groups with interventions (p < 0.001). Two significant differences were found in depressive symptoms: between 1 and 6 months and comparison groups with interventions (p = 0.05). In general, studies have shown that RSI decreased stress, alcoholism and depression. CONCLUSIONS: RCTs on RSI showed additional benefits including reduction of clinical symptoms (mainly anxiety). The diversity of protocols and outcomes associated with a lack of standardization of interventions point to the need for further studies evaluating the use of religiosity/spirituality as a complementary treatment in health care.]
Grossoehme, D. H., Szczesniak, R. D., Britton, L. L., Siracusa, C. M., Quittner, A. L., Chini, B. A., Dimitriou, S. M and Seid, M. [Cincinnati Children's Hospital Medical Center, Cincinnati, OH; University of Alabama Birmingham/Children's Hospital of Alabama Cystic Fibrosis Center, Birmingham, AL; and University of Miami, Miami, FL]. "Adherence determinants in cystic fibrosis: cluster analysis of parental psychosocial, religious, and/or spiritual factors." Annals of the American Thoracic Society 12, no. 6 (Jun 2015): 838-846. [(Abstract:) RATIONALE: Cystic fibrosis is a progressive disease requiring a complex, time-consuming treatment regimen. Nonadherence may contribute to an acceleration of the disease process. Spirituality influences some parental healthcare behaviors and medical decision-making. OBJECTIVES: We hypothesized that parents of children with cystic fibrosis, when classified into groups based on adherence rates, would share certain psychosocial and religious and/or spiritual variables distinguishing them from other adherence groups. METHODS: We conducted a multisite, prospective, observational study focused on parents of children younger than 13 years old at two cystic fibrosis center sites (Site 1, n= 83; Site 2, n = 59). Religious and/or spiritual constructs, depression, and marital adjustment were measured by using previously validated questionnaires. Determinants of adherence included parental attitude toward treatment, perceived behavioral norms, motivation, and self-efficacy. Adherence patterns were measured with the Daily Phone Diary, a validated instrument used to collect adherence data. Cluster analysis identified discrete adherence patterns, including parents' completion of more treatments than prescribed. MEASUREMENTS AND MAIN RESULTS: For airway clearance therapy, four adherence groups were identified: median adherence rates of 23%, 52%, 77%, and 120%. These four groups differed significantly for parental depression, sanctification of their child's body, and self-efficacy. Three adherence groups were identified for nebulized medications: median adherence rates of 35%, 82%, and 130%. These three groups differed significantly for sanctification of their child's body and self-efficacy. CONCLUSIONS: Our results indicated that parents in each group shared psychosocial and religious and/or spiritual factors that differentiated them. Therefore, conversations about adherence likely should be tailored to baseline adherence patterns. Development of efficacious religious and/or spiritual interventions that promote adherence by caregivers of children with cystic fibrosis may be useful.]
Kevern, P. and Hill, L. [Staffordshire University, Stafford, UK]. "'Chaplains for well-being' in primary care: analysis of the results of a retrospective study." Primary Health Care Research and Development 16, no. 1 (Jan 2015): 87-99. [(Abstract:) AIM: To analyse quantitative changes in patient well-being concurrent with chaplaincy interventions in a retrospective study of a group of Primary Care centres in Sandwell and West Birmingham, United Kingdom. BACKGROUND: Anecdotal evidence suggests that support from trained Primary Care Chaplains may be particularly useful for those with subclinical mental health issues; it can reduce the tendency to 'medicalise unhappiness' and is a positive response to patients with medically unexplained symptoms. However, to date there has been no published research attempting to quantify their contribution. METHOD: Data were gathered from a group of Primary Care Centres, which make use of a shared Chaplaincy service. Demographic data and pre-post scores on the Warwick and Edinburgh Mental Wellbeing Scale (WEMWBS) were collected for patients who had attended consultations with a Chaplain. These were subjected to tests of statistical significance to evaluate the possible contribution of chaplaincy to patient well-being along with possible confounding variables. FINDINGS: a substantial improvement in WEMWBS scores (mean=9 points, BCa 95% CI [7.23, 10.79], P=0.001) post-intervention. The improvement in scores was highest for those with initially lower levels of well-being. There is therefore evidence that chaplaincy interventions correlate with an improvement of holistic well-being as measured by a WEMWBS score. A prospective study on a larger scale would provide more detailed information on the interaction of possible variables. Further study is also required to evaluate the implications of this result for patient outcomes and GP resources. The efficacy of Primary Care Chaplaincy is under-researched and difficult to measure. This paper represents the first attempt to quantify a measurable improvement in the well-being of patients who are referred to the service.]
McCarroll, P. R. [Knox College, University of Toronto, Canada]. "Taking inventory and moving forward: a review of the research literature and assessment of qualitative research in JPCC, 2010-2014." Journal of Pastoral Care & Counseling 69, no. 4 (Dec 2015): 222-231. [(Abstract:) As the foremost journal in spiritual care and counseling (SCC), Journal of Pastoral Care and Counseling (JPCC) functions as a barometer for the discipline's research and interests. This article presents the findings of a review of the research literature in JPCC between 2010 and 2014. It examines research articles by asking the following questions: What are the quantity and types of research published? What are the dominant themes in this research? What are the quantity and methodologies of qualitative research? Findings are presented, discussed and recommendations are made in an effort to assess and further build the research base of the discipline.]
Munoz, A. R., Salsman, J. M., Stein, K. D. and Cella, D. [Northwestern University Feinberg School of Medicine, Chicago, IL]. "Reference values of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being: a report from the American Cancer Society's studies of cancer survivors." Cancer 121, no. 11 (Jun 1, 2015): 1838-1844. [(Abstract:) BACKGROUND: Health-related quality of life measures are common in oncology research, trials, and practice. Spiritual well-being has emerged as an important aspect of health-related quality of life and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being; The 12-item Spiritual Well-Being Scale (FACIT-Sp-12) is the most widely used measure of spiritual well-being among those with cancer. However, there is an absence of reference values with which to facilitate the interpretation of scores in research and clinical practice. The objective of the current study was to provide FACIT-Sp-12 reference values from a representative sample of adult cancer survivors. METHODS: As part of the American Cancer Society's Study of Cancer Survivors-II, a national cross-sectional study of cancer survivors (8864 survivors) completed questionnaires assessing demographic characteristics, clinical information, and the FACIT-Sp-12. Scores were calculated and summarized by FACIT-Sp-12 subscale and total scores across age, sex, race/ethnicity, time after treatment, and cancer type. RESULTS: Student t tests for independent samples found that women reported significantly higher FACIT-Sp-12 scores (P<.001). Analyses of variance found significant main effects for FACIT-Sp-12 scores by age (P<.01), race/ethnicity (P<.05), and cancer type (P<.001). Post hoc comparisons revealed that older adults (those aged 60-69 years and 70-79 years) and black non-Hispanic individuals reported the highest FACIT-Sp-12 scores compared with those aged 18 to 39 years (P<.05; Cohen d [an effect size used to indicate the standardized difference between 2 means], 0.20-0.50) and white non-Hispanic individuals (P<.05; Cohen d, 0.02-0.62), respectively. All other significant main effects were small in magnitude (effect size range, 0.001-0.032). CONCLUSIONS: These data will aid in the interpretation of the magnitude and meaning of FACIT-Sp-12 scores, and allow for comparisons of scores across studies.]
Oliver, A., Galiana, L. and Benito, E. [Department of Methodology for the Behavioral Sciences, University of Valencia, Spain]. "Evaluation tools for spiritual support in end of life care: increasing evidence for their clinical application." Current Opinion in Supportive and Palliative Care 9, no. 4 (Dec 2015): 357-360. [(Abstract:) PURPOSE OF REVIEW: To summarize current evidence on evaluation tools for spiritual care, paying special attention to recent validations and new instruments, systematic reviews, recent consensus on spiritual care and its measurement, plus other emergent topics. RECENT FINDINGS: The systematic review resulted in 45 identified studies, 14 of which were considered: five works addressed the need for development and validation of spiritual tools; three studies reviewed tools for spirituality assessment, interventions, or related concepts; three more covered the efforts to define guidelines and priorities for spiritual care and its measurement. Other topics such as pediatric spiritual care, the use of new technologies, or nationwide surveys, also arose. SUMMARY: Recent contributions outline usability traits such as to shorten scales and measurement protocols for maximum respect of patients' quality of life. Other works addressed complicated grief or satisfaction with attention to spiritual care, transcending the patients, family and professionals' focus in on a sort of combined perspective. Further attention to culturally based specific models supporting questionnaires, a deeper understanding of quality of the spiritual care, both for patients and families, or further research on the relation between spiritual care and life span should be welcomed.]
Strehlow, K. and Hewitson, J. [Murdoch University and Royal Perth Hospital, Western Australia]. "The effects of CPE on primary relationships --Is it worth exploring?" Journal of Pastoral Care and Counseling 69, no. 2 (Jun 2015): 78-84. [(Abstract:) Clinical Pastoral Education (CPE) can be a life transforming experience for students, but does it also transform students' primary relationships? An online survey of past CPE students at Royal Perth Hospital, Western Australia, found that--overall--CPE had a positive effect on primary relations in key areas, in particular communication, intimacy and spirituality. Recent relationships were more negatively affected. Some relationships did not survive CPE. Structural and pedagogical implications require further research.]
Taylor, J. J., Hodgson, J. L., Kolobova, I., Lamson, A. L., Sira, N. and Musick, D. [CareNet Counseling East, Greenville, NC]. "Exploring the phenomenon of spiritual care between hospital chaplains and hospital based healthcare providers." Journal of Health Care Chaplaincy 21, no. 3 (2015): 91-107. [(Abstract:) Hospital chaplaincy and spiritual care services are important to patients' medical care and well-being; however, little is known about healthcare providers' experiences receiving spiritual support. A phenomenological study examined the shared experience of spiritual care between hospital chaplains and hospital-based healthcare providers (HBHPs). Six distinct themes emerged from the in-depth interviews: Awareness of chaplain availability, chaplains focus on building relationships with providers and staff, chaplains are integrated in varying degrees on certain hospital units, chaplains meet providers' personal and professional needs, providers appreciate chaplains, and barriers to expanding hospital chaplains' services. While HBHPs appreciated the care received and were able to provide better patient care as a result, participants reported that administrators may not recognize the true value of the care provided. Implications from this study are applied to hospital chaplaincy clinical, research, and training opportunities.]
Thienprayoon, R., Campbell, R. and Winick, N. [Cincinnati Children’s Hospital Medical Center, Cincinnati, OH; Children’s Medical Center Dallas, Dallas, TX; and University of Texas Southwestern, Dallas, TX]. "Attitudes and practices in the bereavement care offered by children's hospitals: a survey of the Pediatric Chaplains Network." Omega - Journal of Death and Dying 71, no. 1 (2015): 48-59. [(Abstract:) Fifty thousand children die annually in the United States. No best practice standard exists regarding what services should be offered by children's hospitals to grieving families. We sought to identify the bereavement services most commonly offered, the departments primarily responsible for their dissemination, whether resources differ based on the patient's diagnosis or place of death, and whether the services offered are adequate. A 13-item anonymous online survey was emailed to 201 pediatric chaplains using the Pediatric Chaplains Network email list. Seventy respondents (34.8%) participated. Respondents described offering a variety of resources, but 47.8% of respondents believe the resources provided are not adequate. Increased staff and financial resources, and more consistency in services provided, were cited as needing improvement. The breadth and depth of bereavement services varies among children's hospitals. More studies are warranted to define the optimal approach to care for families grieving the loss of a child.]
Trevino, K. M. and McConnell, T. R. [Weill Cornell Medical College, New York City, New York, NY; Bloomsburg University, Bloomsburg, PA; and Geisinger Medical Center, Danville, PA]. "Religiosity and spirituality during cardiac rehabilitation: a longitudinal evaluation of patient-reported outcomes and exercise capacity." Journal of Cardiopulmonary Rehabilitation and Prevention 35, no. 4 (Jul-Aug 2015): 246-254. [(Abstract:) PURPOSE: This study is a longitudinal evaluation of religiosity/spirituality (R/S) and religious coping in post-myocardial infarction and post-coronary artery bypass surgery patients during a 12-week cardiac rehabilitation program. This study examines change in R/S and the relationship between R/S and psychosocial outcomes and exercise capacity over time. METHODS: Cardiac rehabilitation patients (N = 105) completed measures of R/S, religious coping, quality of life (QOL), self-efficacy (SE), and energy expenditure (EE) at the beginning (baseline) and end of a 12-week program. Relationships between R/S and religious coping and QOL, SE, and EE were evaluated. RESULTS: A negative relationship emerged between baseline measures of R/S and religious coping and QOL, SE, and EE. There were significant increases in Good Deeds Coping, QOL, SE, and EE from baseline to end of program (Ps < .05). Baseline measures of Interpersonal Religious Support Coping were positively correlated with the change in EE from baseline to end (r = 0.21; P = .059), and there were positive correlations between the change in Experiential Religiosity (r = 0.32; P = .004) and Overall Religiosity (r = 0.25; P = .024) with the change in EE. DISCUSSION: The demonstrated relationships between R/S and Religious Coping and outcomes in cardiac patients provide compelling support for the development of spiritual care interventions for cardiac patients and evaluation of the impact of these interventions on physiological, medical, and psychological outcomes in these patients.]
Yoon, J. D., Shin, J. H., Nian, A. L. and Curlin, F. A. [University of Chicago; Northwestern University; Duke University; and University of California School of Medicine, Irvine]. "Religion, sense of calling, and the practice of medicine: findings from a national survey of primary care physicians and psychiatrists." Southern Medical Journal 108, no. 3 (Mar 2015): 189-195. [(Abstract:) OBJECTIVES: A sense of calling is a concept with religious and theological roots; however, it is unclear whether contemporary physicians in the United States still embrace this concept in their practice of medicine. This study assesses the association between religious characteristics and endorsing a sense of calling among practicing primary care physicians (PCPs) and psychiatrists. METHODS: In 2009, we surveyed a stratified random sample of 2016 PCPs and psychiatrists in the United States. Physicians were asked whether they agreed with the statement, "For me, the practice of medicine is a calling." Primary predictors included demographic and self-reported religious characteristics, (eg, attendance, affiliation, importance of religion, intrinsic religiosity) and spirituality. RESULTS: Among eligible respondents, the response rate was 63% (896/1427) for PCPs and 64% (312/487) for psychiatrists. A total of 40% of PCPs and 42% of psychiatrists endorsed a strong sense of calling. PCPs and psychiatrists who were more spiritual and/or religious as assessed by all four measures were more likely to report a strong sense of calling in the practice of medicine. Nearly half of Muslim (46%) and Catholic (45%) PCPs and the majority of evangelical Protestant PCPs (60%) report a strong sense of calling in their practice, and PCPs with these affiliations were more likely to endorse a strong sense of calling than those with no affiliation (26%, bivariate P < 0.001). We found similar trends for psychiatrists. CONCLUSIONS: In this national study of PCPs and psychiatrists, we found that PCPs who considered themselves religious were more likely to report a strong sense of calling in the practice of medicine. Although this cross-sectional study cannot be used to make definitive causal inferences between religion and developing a strong sense of calling, PCPs who considered themselves religious are more likely to embrace the concept of calling in their practice of medicine.]