Testing the efficacy of chaplaincy care

The current article reviews the research conducted in the United States on the clinical practice of chaplains with patients and family members, referrals to chaplains, patient satisfaction with chaplaincy services, and the limited literature on the efficacy of chaplain interventions. It also discusses the methodological limitations of studies conducted on these topics and makes suggestions for improving future chaplaincy research. The authors conclude that past studies have not adequately defined chaplain interventions, nor sufficiently documented the clinical practice of chaplains, and that more and better designed studies are needed to test the efficacy of chaplaincy interventions. The authors recommend that chaplains generate research-based definitions of spirituality, spiritual care, and chaplaincy practice; and that more research be conducted to describe the unique contributions of chaplains to spiritual care, identify best chaplaincy practices to optimize patient and family health outcomes, and test the efficacy of chaplaincy care.     

Testing the Efficacy of Chaplaincy Care

The current article reviews the research conducted in the United States on the clinical practice of chaplains with patients and family members, referrals to chaplains, patient satisfaction with chaplaincy services, and the limited literature on the efficacy of chaplain interventions. It also discusses the methodological limitations of studies conducted on these topics and makes suggestions for improving future chaplaincy research. The authors conclude that past studies have not adequately defined chaplain interventions, nor sufficiently documented the clinical practice of chaplains, and that more and better designed studies are needed to test the efficacy of chaplaincy interventions. The authors recommend that chaplains generate research-based definitions of spirituality, spiritual care, and chaplaincy practice; and that more research be conducted to describe the unique contributions of chaplains to spiritual care, identify best chaplaincy practices to optimize patient and family health outcomes, and test the efficacy of chaplaincy care.     

Help-Seeking Behaviors Among Active-Duty Military Personnel: Utilization of Chaplains and Other Mental Health Service Providers

Military chaplains not only conduct religious services, but also provide counseling and spiritual support to military service members, operating as liaisons between soldiers and mental health professionals. In this study, active-duty soldiers (N = 889) reported help-seeking behaviors and mental health. Using logistic regressions, we describe the issues for which soldiers reported seeking help, then outline the characteristics of those who are most likely to seek help from a chaplain. Of the soldiers who sought help from a chaplain within the previous year, 29.9% reported high levels of combat exposure, 50.8% screened positive for depression, 39.1% had probable PTSD, and 26.6% screened positive for generalized anxiety disorder. The participant’s unit firing on the enemy, personally firing on the enemy, and seeing dead bodies or human remains predicted seeing a chaplain. Future research should examine ways to engage soldiers who have had more combat experiences with the chaplain community to address spiritual issues.     

Research Priorities for Healthcare Chaplaincy: Views of U.S. Chaplains

Chaplains in the United States and around the world appear to support an evidence-based practice approach to chaplaincy. While there continues to be strong growth in spiritual care research, several spiritual care researchers have stressed the need for a research agenda for chaplaincy. This study investigated the research priorities of chaplains who completed a survey distributed at four chaplaincy conferences in 2016. A total of 193 chaplains responded, resulting in 499 comments. When compared to the findings of existing literature regarding research priorities for chaplaincy, chaplain’s views of research priorities appear to be very consistent with views of chaplaincy leaders. Both prioritize research on outcomes of spiritual care, the development and testing of the effectiveness of interventions, the development and evaluation of assessment and screening tools and research about key subgroups of patients. The chaplains in the survey however added to the agenda research regarding competencies, education, and certification and research regarding the chaplain and the team.     

Exploring the Phenomenon of Spiritual Care Between Hospital Chaplains and Hospital Based Healthcare Providers

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.     

Chaplaincy and Narrative Theory: A Response to Risk's Case Study

The response of a clinical chaplain to a case study of chaplaincy with an elderly African-American male with Parkinson's disease is presented. The case study offers two novel aspects: first, it explicitly describes interventions by the chaplain, and second, the chaplain's clinical approach was guided throughout by an underlying theory (narrative theory). The case study seeks to shift the paradigm from chaplains as “agenda-less” companions to clinicians with a repertoire of interventions which they should claim. The chaplain's use of narrative theory is examined. Future case studies may draw on narrative theory in chaplaincy with older males with different chronic disease, with women who have Parkinson's, and may seek to develop a theory of chaplaincy from within the profession.     

Shema,Vidui, Yivarechecha: What to Say and How to Pray with Jewish Patients in Chaplaincy

A 90-minute focus group was conducted with five male and two female Jewish professional chaplains from Reform, Conservative, and Orthodox backgrounds. This study describes and discusses eight principal themes that emerged from the focus group: (a) the identity, (b) role, and (c) practices of a chaplain; (d) Jewish chaplaincy prayers; (e) practices for chronic versus acute care; (f) patients' reactions to the chaplain's gender; (g) general and spiritual interventions; and, finally, (h) challenges in chaplaincy.     

A State Health Service and Funded Religious Care

This paper analyses the role chaplaincy plays in providing religious and spiritual care in the UK’s National Health Service. The approach considers both the current practice of chaplains and also the wider changes in society around beliefs and public service provision. Amid a small but growing literature about spirituality, health and illness, I shall argue that the role of the chaplain is changing and that such change is creating pressures on the identity and performance of the chaplain as a religiously authorised health worker. I shall question whether either orthodox belief or religious belonging have any significant bearing on the patients’ demand for chaplaincy services. Utilising an example of chaplaincy work I shall argue that patient need constitutes the strongest platform for both practice development and an articulated understanding of what chaplains bring to health care. Drawing on a case study the definition and interpretation of spiritual need will be discussed in relation to chaplaincy practice. In conclusion, I shall set out the case for effective research to establish with greater precision the detail of the chaplain’s practice within a state-funded health system.     

Touched by an Angel: A Chaplain's Response to the Case Study's Key Interventions,Styles, and Themes/Outcomes

This article is a response by a long-term oncology chaplain to a case by another oncology chaplain. The author notes interventions key to the relationship and outcomes, highlights differences in chaplaincy styles, and summarizes significant outcomes that are common in oncology chaplaincy. The purpose of the response is to further demonstrate how chaplains think about and engage patients/families in chaplaincy care as well as to stimulate the reflective process of the readers of the case study.     

Touched by an angel: a chaplain's response to the case study's key interventions, styles, and themes/outcomes

This article is a response by a long-term oncology chaplain to a case by another oncology chaplain. The author notes interventions key to the relationship and outcomes, highlights differences in chaplaincy styles, and summarizes significant outcomes that are common in oncology chaplaincy. The purpose of the response is to further demonstrate how chaplains think about and engage patients/families in chaplaincy care as well as to stimulate the reflective process of the readers of the case study.     

信息化条件下战伤分类后送的组织与实施

本文总结了信息化条件下战争、战伤特点及战伤救治分类后送的组织与实施,建议我军借鉴美军的经验,在组织战场卫勤保障时,建立类似的抢救组,实施超前机动保障,医疗救治前伸,缩短首治时间,调整适应三军联勤保障的整体运作方式,减少分级救治环节,确保伤病员快抢、快救、快送。旨在探索将移动ICU前移至战场一线,提高战创伤救治成功率的可能性,从而实现＂医疗与伤员同在＂的卫勤保障新理念。     

Patient and family perceptions of hospital chaplains

While most hospitals provide chaplaincy services for patients, families, and staff, these services are seldom studied and their contribution is poorly understood. A questionnaire created by the College of Chaplains of the American Protestant Health Association was mailed by an insurance company to patients recently dismissed from the hospital, requesting evaluation of three non-medical services (social services, chaplaincy, and patient representatives) and how well the spiritual needs for support/counseling, prayer, and sacraments were met. Responses revealed that, in comparison to the other two non-medical services, patients receive more visits from chaplains, evaluate these visits as more important (p less than 0.000), and report that these visits meet their expectations more highly (p less than 0.000). Regression analyses demonstrate that when the chaplain meets the patient's need for support/counseling, the respondent is more likely to select the hospital again (p = 0.04) and recommend it to others (p = 0.05). Similarly, when chaplains meet the family's need for support/counseling, the respondent is likely to choose the hospital again. Since chaplains clearly make an important contribution to patients, their families, and the hospital, administrators should review the adequacy of their chaplaincy services in the light of these data.     

Patients' Satisfaction with Health Care Chaplaincy and Affecting Factors: An Exploratory Study in the German Part of Switzerland

Surveying patients' satisfaction with chaplaincy services contributes to improving the quality of health care chaplaincy. Therefore, 679 patients from 32 general hospitals and psychiatric clinics in the German part of Switzerland were surveyed in a cross-sectional design. Seven factors influencing patients' satisfaction with health care chaplaincy were identified. They pertain, on one hand, to the chaplain–patient relationship (“Respect and friendliness,” “Empathy,” “Negative relationship”) and, on the other hand, to the evaluation of chaplains' interventions (“Religious/spiritual interventions,” “Religious/spiritual issues,” “Clarification, coping and support,” “Conflict management and forgiveness”). Whereas the patient–chaplain relationship was significantly associated with the patient's age and religiosity, the apprehension of pastoral intervention was significantly associated with the patient's religiosity and denomination, length of stay, admission to hospital, and the patient's health status. The results suggest that chaplains have to take account of the situational circumstances and personal characteristics of patients in order to optimize their service.     

Introduction to the Discipline for pastoral care giving

During the last eight years, the professional chaplains of Spiritual Care Services at Barnes-Jewish Hospital-Washington University Medical Center (BJH) have developed a discipline based, outcome-oriented model for chaplaincy. This article introduces the elements of The Discipline, our development process, the effects on our chaplaincy attributable to its consistent use, and implications for the future. While many of our assumptions about chaplaincy have been challenged, our experience is that a disciplined, outcome-oriented model for chaplaincy has deepened our relationships with patients and significantly increased our integration into the care teams of the hospital. It has also challenged and enhanced our abilities to be emotionally present with patients while also giving attention to the process of the visits and chaplain interventions that contribute to patient healing and well-being.     

A Review of: “Have a Little Faith: A True Story (Hardcover).”

To date, the field of health care chaplaincy has had little information about how pediatric palliative care (PPC) programs meet the spiritual needs of patients and families. We conducted a qualitative study consisting of surveys of 28 well-established PPC programs in the United States followed by interviews with medical directors and professional chaplains in 8 randomly selected programs among those surveyed. In this report, we describe the PPC chaplain activities, evidence regarding chaplain integration with the PPC team, and physician and chaplain perspectives on the chaplains' contributions. Chaplains described their work in terms of processes such as presence, while physicians emphasized outcomes of chaplains' care such as improved communication. Learning to translate what they do into the language of outcomes will help chaplains improve health care colleagues' understanding of chaplains' contributions to care for PPC patients and their families. In addition, future research should describe the spiritual needs and resources of PPC patients and families and examine the contribution chaplains make to improved outcomes for families and children facing life-limiting illnesses.     

Research Priorities for Health Care Chaplaincy in The Netherlands: A Delphi Study Among Dutch Chaplains

The aim of this study was to identify research priorities for health care chaplaincy in The Netherlands according to practicing chaplains and chaplaincy leaders. To this end, a two-round Delphi study was conducted. The first round in which participants were asked to list at least three research priorities was completed by 249 respondents. Through content analysis, the resulting 811 priorities were merged into 54 research topics in 10 domains. In the second round, 179 respondents ranked these topics on a Likert scale from 1 to 5 (low priority–high priority) from the perspective of the patient/client, the organization, and the profession. Based on the mean score of each topic, five research priorities were identified: (a) to investigate the effect of chaplain care according to the patient/client; (b) to determine the patients’/clients’ need(s) for chaplaincy; (c) to investigate the effect of chaplain care on the patient/client; (d) to identify possibilities for chaplaincy practice in outpatient care; and (e) to investigate how to develop a stronger profile for chaplaincy in The Netherlands. These priorities resonate with research on this topic from other countries and indicate directions for future research efforts to improve chaplaincy care.     

Selected Findings from the “New York” and the “Metropolitan” Chaplaincy Studies: A 10-Year Comparison of Chaplaincy in the New York City Area

In recent years, the chaplain-to-patient ratio in U.S. hospitals has remained roughly the same while the role of the hospital chaplain has expanded. We compared data on 33,000 chaplain visits from the New York Chaplaincy Study (1994–1996) with 58,000 chaplain visits from the Metropolitan Chaplaincy Study (2005–2006), in order to explore whether changes in both the role of the healthcare chaplain and changes in the healthcare system itself have affected the amount of time that chaplains are able to spend with patients. The overall pattern of lengths of visits was stable over time, but chaplains in the Metropolitan Chaplaincy Study had proportionally fewer visits with family members and more visits with patients, more visits based on referrals, and spent more time dealing with end-of-life issues than chaplains in the earlier New York Chaplaincy Study. We discuss ways that chaplains seem to be adjusting successfully to increasing demands on their time.     

Making our case(s)

Health care chaplaincy needs to develop a body of published case studies. Chaplains need these case studies to provide a foundation for further research about the efficacy of chaplains' spiritual care. Case studies can also play an important role in training new chaplains and in continuing education for experienced chaplains, not to mention educating health care colleagues and the public about the work of health care chaplains. Guidelines for writing case studies are described, herein, as is a project in which three experienced oncology chaplains worked together to write case studies about their work. Steps that chaplains, and professional chaplain organizations, can take to further the writing and publishing of case studies are described.     

“I see so much in them”: Australian Chaplains telling an alternative narrative of adolescents in the justice system

This qualitative study aims to provide insight into the impact of chaplaincy in the Australian juvenile justice system. Semi‐structured qualitative interviews were conducted with six chaplains and managers of chaplaincy services in the juvenile justice system in Victoria, Australia. Interviews were analysed thematically using deductive and inductive coding. Four themes emerged relating to the role and impact of the chaplain: to establish a safe and trusting relationship with the adolescents, to convey love and belonging, to engage the adolescents in meaning making, and to help adolescents to realise their full potential. These themes are consistent with Maslow's Hierarchy of Needs. Two themes emerged regarding how to increase the reach of chaplaincy: through recognising chaplaincy as an integral part of the justice system and enabling chaplains to work with the adolescents and their families post‐release. While limited by a small sample, this study represents all organisations that provide chaplaincy in the juvenile justice system in Victoria, Australia. Future research could include the voices of the adolescents in juvenile justice, to gain their perspective on the role and impact of chaplaincy services.