Chaplaincy Research: Its Value,Its Quality,and Its Future

The article is divided into four major sections, the first of which presents and discusses various reasons given by major researchers in the field why chaplains should do research. The second section summarizes findings on the sophistication of research on religion and health published in (a) medical and other healthcare journals, and (b) specialty journals on religion and health, chaplaincy, and pastoral care and counseling. The third section revisits suggestions that have been made by prominent chaplain researchers to increase and improve research by chaplains. The last section offers some suggestions for expanding several lines of current research in the future, including research: (1) to elucidate the nature of spiritual care chaplains provide to different populations, including patients, families and staff; (2) to assess the prevalence and intensity of patients' spiritual needs and the degree to which they are being met; (3) to identify that subset of patients who are spiritually at risk in terms of having high needs and slow religious resources; (4) to identify the biological causal mechanisms by which religion influences health; and (5) to measure the effectiveness of chaplain interventions.     

Rocky Mountain Pastoral Care and Training Associates,Littleton, Colorado

SUMMARY

This article uses a sibling metaphor to outline the relationship between science and spirituality. This metaphor forms the backdrop for exploring several directions in spiritual care research. It argues that science and functional spirituality were born as siblings and need to dance now without either estrangement or incest, intent on measuring the material effects of excellent pastoral care.     

Abstract

The reuse of subjects in clinical studies to answer specific research questions is a common practice. This reuse can take many forms and is at least partly related to study efficiency. It is much easier to reuse known subjects who know the system(s) or are easy to find than to recruit new ones. A hypothetical question is: Are there instances when such practices may not be scientifically valid? This question will be addressed from the perspective of the case‐control and experimental study design.     

Factors Associated with Asthma Control among Adults in Five New England States, 2006–2007

Background. Despite the National Asthma Education and Prevention Program (NAEPP) guidelines that specify the goals of asthma control and management strategies, the number of patients with uncontrolled asthma remains high, and factors associated with uncontrolled asthma are unknown. Objective. The aim was to examine the relationship between asthma control and socio-demographic characteristics, health-care access and use, asthma education, and medication use among adults with active asthma residing in New England. Methods. Data from the 2006–2007 Behavior Risk Factor Surveillance System Adult Asthma Call-Back Survey were analyzed using multinomial logistic regression. Asthma control was categorized as “well controlled,” “not well controlled,” or “very poorly controlled” according to the NAEPP guidelines. Results. Of the respondents (n = 3079), 30% met the criteria for well-controlled asthma, 46% for not well-controlled asthma, and 24% for very poorly controlled asthma. Being of Hispanic ethnicity (odds ratio [OR] = 4.0; 95% confidence interval [CI] = 1.2–13.7), unemployed or unable to work (OR = 17.9; 95% CI = 6.0–53.4), high school educated or less (OR = 2.8; 95% CI = 1.6–4.7), current smokers (OR = 2.5; 95% CI = 1.3–5.1), or being unable to see a doctor or specialist for asthma care or unable to buy medication for asthma because of cost (OR = 7.6; 95% CI = 3.4–17.1) were associated with very poorly controlled asthma. In addition, having Coronary Obstructive Pulmonary Disease (COPD) (OR = 2.6; 95% CI = 1.5–4.5), two or more routine checkups for asthma (OR = 4.5; 95% CI = 2.3–8.9), or an emergency department visit, urgent care facility visit, and hospitalization in the past year (OR = 3.9; 95% CI = 2.1–7.3) were also associated with having very poorly controlled asthma. Using controller medication in the past year (OR = 2.6; 95% CI = 1.6–4.2) and taking a course on how to manage asthma (OR = 3.0; 95% CI = 1.2–7.8) were significantly associated with poor asthma control. Conclusion. The high prevalence (70%) of not well-controlled asthma and poorly controlled asthma in this study emphasizes the need to identify factors associated with poor asthma control for development of targeted intervention. A health policy of increasing asthma education, health-care access, and smoking cessation may be effective and result in better asthma control and management.     

Research in Nursing:

No abstract available for this article.     

Patient-Centered Education: Applying Learner-Centered Concepts to Asthma Education

Objective. To review studies of patient-centered asthma education. Method. CINAHL, Medline, Psycinfo, Eric, PsycARTICLES, and web of science databases were searched. Results Asthma education programs are often based on health behavior theories. Many studies lack rigor in the assessment of the program's efficacy and effectiveness. Asthma education that promotes self-management primarily uses a problem-based approach. Few studies have examined the way educators teach and patients learn. Patient-centered approaches to education have mainly focused on communication between the patient and the health professional. Decision making as part of shared responsibility may vary with every patient. Patient-centered care shares similarities with the Self-Determination Theory as a learner-centered approach to education. Conclusions. Many asthma education studies have been completed with varying levels of efficacy and effectiveness reported. Most programs focus on changing behavior with few studies examining educator behavior and/or the patient's learning styles. With a patient-centered approach being the preferred model of care, the incorporation of learner-centered approaches to patient education may prove useful in the future.     

Judgments About Elder Abuse and College Students' Relationship with Grandparents

Abstract

Using brief scenarios describing adult caregiver/elder parent interactions, college students made judgments about how justifiable aggressive behavior by caregivers were, the abusiveness of these behaviors, and the abusiveness of the behavior of the elderly parent. The extent of students' contact with their grandparents was obtained. Results indicate that judgments of abusiveness are context specific, and that senile or agitated elders were viewed as more abusive, and behaviors against them as more justified, than were more “helpless” elders. In addition, results indicate that students' involvement with grandparents has an effect on the judgments of abusiveness and the justifiability of caregiver behaviors toward elderly mothers. It is suggested that programs that promote interaction between younger and older persons should be encouraged in order to develop a heightened understanding between these age groups and to help relieve generational tensions that may exist.     

The Nurse Practitioners-Physician Team in Nursing Home Practice

Development and effectiveness of a Family Nurse Practitioner-Physician faculty team is providing health care to nursing home residents and educational experiences to Family Practice residents is evaluated. Indicated changes in the educational program and implications for faculty teams are given.