RESUMEN
This article invites theological school educators, clinical pastoral education educators, representatives of the professional healthcare chaplaincy organizations, and social scientists to begin a shared conversation about chaplaincy education. To date, we find that theological educators, clinical educators, professional chaplains, and the healthcare organizations where they work are not operating from or educating toward a common understanding of what makes healthcare chaplains effective. Before we identify five key questions that might help us be in shared conversation and move towards educating the most effective chaplains, we briefly describe the history of education for healthcare chaplaincy. We then describe what we learned in interviews in 2018 with 21 theological and 19 clinical educators who are educating healthcare chaplains in theological schools and clinical pastoral education residency programs, year-long educational programs in hospitals and other settings that focus on preparing people for staff chaplain jobs. Their different approaches and frames inform the five questions with which we conclude.
Asunto(s)
Servicio de Capellanía en Hospital/tendencias , Cuidado Pastoral/educación , Competencia Profesional/normas , Religión y Medicina , Catolicismo , Clero/estadística & datos numéricos , HumanosRESUMEN
BACKGROUND: Discussion of religion and/or spirituality in the medical consultation is desired by patients and known to be beneficial. However, it is infrequent. We aimed to identify why this is so. AIM: We set out to answer the following research questions: Do doctors report that they ask their patients about religion and/or spirituality and how do they do it? According to doctors, how often do patients raise the issue of religion and/or spirituality in consultation and how do doctors respond when they do? What are the known facilitators and barriers to doctors asking their patients about religion and/or spirituality? DESIGN: A mixed qualitative/quantitative review was conducted to identify studies exploring the physician's perspective on discussion of religion and/or spirituality in the medical consultation. DATA SOURCES: We searched nine databases from inception to January 2015 for original research papers reporting doctors' views on discussion of religion and/or spirituality in medical consultations. Papers were assessed for quality using QualSyst and results were reported using a measurement tool to assess systematic review guidelines. RESULTS: Overall, 61 eligible papers were identified, comprising over 20,044 physician reports. Religion and spirituality are discussed infrequently by physicians although frequency increases with terminal illness. Many physicians prefer chaplain referral to discussing religion and/or spirituality with patients themselves. Such discussions are facilitated by prior training and increased physician religiosity and spirituality. Insufficient time and training were the most frequently reported barriers. CONCLUSION: This review found that physician enquiry into the religion and/or spirituality of patients is inconsistent in frequency and nature and that in order to meet patient needs, barriers to discussion need to be overcome.
Asunto(s)
Actitud del Personal de Salud , Médicos/psicología , Religión y Medicina , Espiritualidad , Enfermo Terminal/psicología , Servicio de Capellanía en Hospital/tendencias , Comunicación , Barreras de Comunicación , Bases de Datos Bibliográficas , Humanos , Relaciones Médico-Paciente , Pautas de la Práctica en Medicina/tendencias , Derivación y Consulta/tendenciasRESUMEN
PURPOSE OF REVIEW: Clinical works at the intersection of 'spirituality, religion, theology and medicine' are studied to identify various aspects of what constitutes spirituality, what contributes to spiritual health and how to provide spiritual-healers for our current health-care system. RECENT FINDINGS: Spiritual care in the current medical world can be classed grossly into two departments: complementary and alternative medicine, considered as proxy variable for spirituality, and physician-initiated clinical Chaplaincy, informed by theology. The large body of research on 'self' as a therapeutic tool, though, falls into subtle categories: phenomenological studies, empathy, embodied care, and mindfulness-based therapies. Development in the field of 'spiritual medicine' has focused on spirituality-related curricula. SUMMARY: As mindfulness-based meditation programs help build deep listening skills needed to stay aware of the 'self', Clinical Pastoral Education trains the chaplain to transcend the 'self' to provide embodied care. Clinical chaplaincy is the destination for health-care professionals as well as theological/religious scholars who have patients' spiritual health as their primary focus. Medical education curricula that train students in chaplain's model of transpersonal-mindfulness/empathy founded on neuro-physiological principles would help them gain skills in embodied care. Such education would seamlessly integrate evidence-based clinical practice and spiritual-theological concepts.
Asunto(s)
Terapias Complementarias , Meditación , Atención Plena , Cuidado Pastoral/educación , Religión y Medicina , Espiritualidad , Servicio de Capellanía en Hospital/tendencias , Empatía , Humanos , Religión , Religión y Psicología , TeologíaRESUMEN
OBJECTIVES: To compare quality of end-of-life (EOL) care indicators and family evaluation of care in community living centers (CLCs) with that of EOL care in acute, intensive, and hospice and palliative care units. DESIGN: Retrospective chart review and survey with next of kin of recently deceased inpatients. SETTING: Inpatient Veterans Affairs (VA) Medical Centers (N = 145), including 132 CLCs, across the United States. PARTICIPANTS: The chart review included all individuals who died in VA inpatient units (n = 57,397). Family survey results included data for 33,497 veterans. MEASUREMENTS: Indicators of optimal EOL care: palliative consultation in the last 90 days of life, contact with a chaplain, family contact with a chaplain, and emotional support given to family after death. The main outcome was a single Bereaved Family Survey item in which respondents provided a global evaluation of quality of EOL care (excellent to very good, good, fair to poor). RESULTS: Family evaluations of overall EOL care and quality of EOL care indicators for veterans who died in CLCs were better than those of veterans dying in acute or intensive care units but worse than those dying in hospice or palliative care units. CONCLUSION: Care in CLCs can be enhanced through the integration of palliative care practices. Future research should identify critical elements of enhancing EOL care in nursing homes.
Asunto(s)
Hospitales de Veteranos/tendencias , Cuidado Terminal/tendencias , Anciano , Anciano de 80 o más Años , Servicio de Capellanía en Hospital/tendencias , Recolección de Datos , Familia , Femenino , Cuidados Paliativos al Final de la Vida/tendencias , Humanos , Masculino , Calidad de la Atención de Salud , Estudios Retrospectivos , Estados UnidosRESUMEN
AIMS AND BACKGROUND: Adolescents with cancer have psychosocial issues that need to be adequately addressed. Spirituality is a fundamental aspect of their psychological well-being. METHODS: A chaplain is a daily presence in the Youth Project ward for adolescents at the Pediatric Oncology Unit of the Istituto Nazionale Tumori, Milan. The chaplain conducts daily visits to the ward and the outpatient clinic/day hospital, holds daily meetings with the psychologists on staff, and attends biweekly meetings with doctors and/or nurses. The cases of patients referred for spiritual assistance between January and December 2012 were analyzed by patient age and reasons for consultation, and were compared with cases referred for psychological consultation. RESULTS: A psychological consultation was offered to 84% of patients/families, and further support was needed for 23% of children and 45% of teenagers. Spiritual support was provided for 2 children and 20 adolescents (24% of the sample considered). CONCLUSIONS: Acknowledgment of their spiritual needs helps patients to battle with their disease. The reasons patients and parents ask for spiritual assistance only partially overlap with the motives behind requests to see a psychologist. The care of adolescents with cancer should include catering for their spiritual needs by assuring the constant presence of a chaplain on hospital wards.
Asunto(s)
Servicio de Capellanía en Hospital , Clero , Muerte , Miedo , Neoplasias/psicología , Derivación y Consulta , Espiritualidad , Adolescente , Ira , Servicio de Capellanía en Hospital/organización & administración , Servicio de Capellanía en Hospital/normas , Servicio de Capellanía en Hospital/tendencias , Niño , Familia , Femenino , Culpa , Humanos , Masculino , Grupo Paritario , Apoyo Social , Adulto JovenRESUMEN
Within the course of medical care in the most advanced health care settings, an increasing attention is being paid to the so-called care humanization. According to this perspective, we try to integrate the usual care pathways with aspects related to the spiritual and religious dimension of all people and their families, as well as the employees themselves. It is clearly important to establish this kind of practices on the basis of scientific evidences. That is the reason why it's a necessity to improve the knowledge about the importance that spiritual assistance can offer within the current health service. The aim of this work is to show the relevance of the integration of spiritual perspectives in the hospital setting according to a multidisciplinary point of view. In this work many data that emerge from the international scientific literature, as well as the definition that is given to the concept of "spirituality" are analyzed; about this definition in fact there is not unanimous consent even today. It is also analyzed the legal situation in force within the European territory according to the different laws and social realities. Finally, the possible organizational practices related to spiritual support are described and the opportunity to specific accreditation pathways and careful training of chaplains able to integrate traditional religious practices with modern spiritual perspectives is discussed.
Asunto(s)
Servicio de Capellanía en Hospital/tendencias , Cuidado Pastoral/tendencias , Grupo de Atención al Paciente/tendencias , Espiritualidad , Servicio de Capellanía en Hospital/organización & administración , Hospitales/tendencias , Humanos , Italia , Grupo de Atención al Paciente/organización & administración , Religión y MedicinaRESUMEN
AIMS AND BACKGROUND: This literature review investigates the potential contribution of the pastoral care provided in hospitals by hospital chaplains, as part of an integrated view of patient care, particularly in institutions dealing with severe disease. METHODS AND STUDY DESIGN: A search was conducted in the Medline database covering the last 10 years. RESULTS: Ninety-eight articles were considered concerning the modern hospital chaplains' relationships and the principal procedures and practices associated with their roles, i.e., their relations with the scientific world, with other religious figures in the community, with other faiths and religious confessions, with other public health professionals and operators, with colleagues in professional associations and training activities, and with the hospital organization as a whole, as well as their patient assessment activities and the spiritual-religious support they provide, also for the patients' families. CONCLUSIONS: Improvements are needed on several fronts to professionalize the pastoral care provided in hospitals and modernize the figure of the hospital chaplain. These improvements include better relations between modern chaplains and the hospital organization and scientific world; more focus on a scientific approach to their activities and on evaluating the efficacy of pastoral care activities; greater clarity in the definition of the goals, methods and procedures; the design of protocols and a stance on important ethical issues; respect for the various faiths, different cultures and both religious and nonreligious or secularized customs; greater involvement in the multidisciplinary patient care teams, of which the hospital chaplains are an integral part; stronger integration with public health operators and cooperation with the psychosocial professions; specific training on pastoral care and professional certification of chaplains; and the development of shared ethical codes for the profession.
Asunto(s)
Servicio de Capellanía en Hospital , Cuidado Pastoral , Grupo de Atención al Paciente , Religión y Medicina , Espiritualidad , Servicio de Capellanía en Hospital/organización & administración , Servicio de Capellanía en Hospital/tendencias , Humanos , Neoplasias/psicología , Neoplasias/terapia , Cuidado Pastoral/métodos , Cuidado Pastoral/tendencias , Grupo de Atención al Paciente/organización & administración , Grupo de Atención al Paciente/tendencias , Reino Unido , Estados UnidosRESUMEN
Over the past 25 years, the Joint Commission for the Accreditation of Healthcare Organizations has changed its guidelines regarding religious/spiritual care of hospitalized patients to increase attention concerning this aspect of hospital-based care. Little empirical evidence assesses the extent to which hospitals relied on hospital chaplains as care providers during these years. This study investigates (1) the extent of chaplaincy service availability in US hospitals between 1980 and 2003; (2) the predictors of having chaplaincy services in 1993 and 2003; and (3) the change in the magnitude of these predictors between years. This study examines the presence or absence of chaplaincy or pastoral care services in hospitals using the American Hospital Association Annual Survey of Hospitals (ranging from 4,946-6,353 hospitals) in 1980-1985, 1992-1993, and 2002-2003. Between 54% and 64% of hospitals had chaplaincy services between 1980 and 2003, with no systematic trend over this period. In 1993 and 2003, hospital size, location, and church affiliation were central factors influencing the presence of chaplaincy services. Smaller hospitals and those in rural areas were less likely to have chaplaincy services. Church-operated hospitals were much more likely to have chaplaincy services; but between 1993 and 2003, church-operated hospitals were more likely to drop chaplaincy services than to add them. Not-for-profit hospitals were more likely than investor-owned hospitals to add chaplaincy services. Changes to Joint Commission for the Accreditation of Healthcare Organizations policies about the religious/spiritual care of hospitalized patients between 1980 and 2003 seem to have had no discernible effect on the fraction of US hospitals that had chaplaincy services. Rather, characteristics of hospitals, their surroundings, and their religious affiliations influenced whether they provided chaplaincy services to patients.
Asunto(s)
Servicio de Capellanía en Hospital/provisión & distribución , Relaciones Interprofesionales , Grupo de Atención al Paciente/estadística & datos numéricos , Religión y Medicina , Servicio de Capellanía en Hospital/organización & administración , Servicio de Capellanía en Hospital/tendencias , Conducta Cooperativa , Recolección de Datos , Predicción , Adhesión a Directriz/estadística & datos numéricos , Adhesión a Directriz/tendencias , Guías como Asunto , Humanos , Joint Commission on Accreditation of Healthcare Organizations , Grupo de Atención al Paciente/organización & administración , Grupo de Atención al Paciente/tendencias , Estados UnidosAsunto(s)
Servicio de Capellanía en Hospital , Cuidado Pastoral , Rol Profesional , Calidad de la Atención de Salud/ética , Espiritualidad , Cuidado Terminal , Certificación , Servicio de Capellanía en Hospital/economía , Servicio de Capellanía en Hospital/normas , Servicio de Capellanía en Hospital/tendencias , Enfermedad Crítica/psicología , Muerte , Servicio de Urgencia en Hospital/tendencias , Familia , Pesar , Cuidados Paliativos al Final de la Vida/tendencias , Humanos , Unidades de Cuidados Intensivos/tendencias , Perfil Laboral , Cuidados Paliativos/tendencias , Cuidado Pastoral/ética , Cuidado Pastoral/tendencias , Satisfacción del Paciente , Calidad de la Atención de Salud/tendencias , Mecanismo de Reembolso , Sociedades , Encuestas y Cuestionarios , Cuidado Terminal/ética , Cuidado Terminal/tendencias , Enfermo Terminal/psicología , Centros Traumatológicos/tendencias , Estados Unidos , Recursos HumanosAsunto(s)
Servicio de Capellanía en Hospital , Cuidado Pastoral , Atención Dirigida al Paciente , Rol Profesional , Garantía de la Calidad de Atención de Salud , Calidad de la Atención de Salud , Servicio de Capellanía en Hospital/ética , Servicio de Capellanía en Hospital/tendencias , Objetivos , Humanos , Atención Dirigida al Paciente/ética , Atención Dirigida al Paciente/normas , Atención Dirigida al Paciente/tendencias , Garantía de la Calidad de Atención de Salud/normas , Garantía de la Calidad de Atención de Salud/tendencias , Calidad de la Atención de Salud/ética , Calidad de la Atención de Salud/normas , Calidad de la Atención de Salud/tendencias , Estados UnidosAsunto(s)
Servicio de Capellanía en Hospital/ética , Servicio de Capellanía en Hospital/tendencias , Clero , Rol Profesional , Calidad de la Atención de Salud , Religión , Empleos Relacionados con Salud , Clero/ética , Clero/normas , Clero/tendencias , Conducta Cooperativa , Administradores de Hospital , Humanos , Calidad de la Atención de Salud/economía , Calidad de la Atención de Salud/ética , Calidad de la Atención de Salud/tendencias , Teología , Estados Unidos , Recursos HumanosAsunto(s)
Servicio de Capellanía en Hospital/ética , Servicio de Capellanía en Hospital/tendencias , Clero , Cuidado Pastoral/ética , Rol Profesional , Calidad de la Atención de Salud/ética , Religión , Responsabilidad Social , Clero/ética , Clero/normas , Clero/tendencias , Conflicto Psicológico , Teoría Ética , Ética Clínica , Ética Médica , Humanos , Obligaciones Morales , Calidad de la Atención de Salud/tendencias , Espiritualidad , Estados Unidos , Recursos HumanosAsunto(s)
Servicio de Capellanía en Hospital/ética , Servicio de Capellanía en Hospital/tendencias , Eticistas , Calidad de la Atención de Salud/ética , Comunicación , Conducta Cooperativa , Humanos , Guías de Práctica Clínica como Asunto , Calidad de la Atención de Salud/tendencias , Sociedades , Estados UnidosRESUMEN
This review article provides insight into the evolution of professional healthcare chaplaincy. It identifies key historical developments identifying the training, qualifications, and competencies of chaplains. Consideration is given to both the unique character of the pastoral role in healthcare as well as the contribution of chaplains to the interdisciplinary care of patients and families. The article points to the emerging need for chaplains to pursue research within the clinical context.
Asunto(s)
Servicio de Capellanía en Hospital/tendencias , Clero/tendencias , Cuidado Pastoral/tendencias , Certificación , Servicio de Capellanía en Hospital/normas , Clero/psicología , Salud de la Familia , Humanos , Cuidado Pastoral/educación , Cuidado Pastoral/organización & administración , Grupo de Atención al Paciente , Competencia Profesional , Rol Profesional , EspiritualidadAsunto(s)
Servicio de Capellanía en Hospital/tendencias , Clero , Cuidado Pastoral/tendencias , Rol Profesional , Catolicismo , Certificación , Servicio de Capellanía en Hospital/normas , Educación Profesional/organización & administración , Curación por la Fe , Humanos , Cuidado Pastoral/educación , Cuidado Pastoral/normas , Religión y Psicología , Estados UnidosRESUMEN
The Clinical Pastoral Education (CPE) model for the provision of spiritual care represents the emergence of a secularized professional practice from a religiously-based theological practice of chaplaincy. The transformation of hospital chaplaincy into "spiritual care services" is one means by which religious healthcare ministry negotiates modernity, in the particular forms of the secular realm of biomedicine and the pluralism of the contemporary United States healthcare marketplace. "Spiritual" is a label strategically deployed to extend the realm of relevance to any patient's "belief system:" regardless of his or her religious affiliation. "Theological" language is recast as a tool for conceptualizing the "spiritual lens:' Such moves transform chaplaincy from a peripheral service, applicable only to the few "religious" patients, into an integral element of patient care for all. Such a secularized professional practice is necessary to demonstrate the relevance and utility of spiritual care for all hospital patients in an era of cost-containment priorities and managed care economics.