By Eric J. Hall, president & CEO, HealthCare Chaplaincy Network
When the latest Clinical Practice Guidelines for Quality Palliative Care guidelines were announced at last year’s AAHPM annual conference, project co-chair Betty Ferrell, PhD, RN, FAAN, FPCN, research scientist at City of Hope, said, “Quality palliative care includes all eight domains. If you are not providing excellent spiritual care, you are not providing palliative care.”
Nonetheless hospital administrators who are skeptical about the value of professional chaplaincy care need data about what chaplains do and their contributions to better patient care.
The first large-scale attempt at forming an evidence base for chaplaincy care effectiveness in health care has culminated in six studies funded by the John Templeton Foundation under a grant managed by HealthCare Chaplaincy Network. The findings were released the inaugural conference of HealthCare Chaplaincy Network’s first annual conference Caring for the Human Spirit: Driving the Research Agenda in Spiritual Care in Health Care March 31 – April 3, 2014, at the New York Academy of Medicine:
Spiritual Assessment and Intervention Model (AIM) in Outpatient Palliative Care for Patients with Advanced Cancer. University of California, San Francisco; Project Director, Laura Dunn, MD, Project Chaplain, Allison Kestenbaum, BCC
This is one of very few studies to provide an in-depth picture of spiritual care work with patients. No validated spiritual assessment tools have existed prior to this study. Even three sessions with a professional chaplain had important, positive effects for patients. The research raises the possibility that spiritual care should be studied as a potentially powerful intervention for patients with various serious illnesses, not just cancer.
Impact of Hospital-Based Chaplain Support on Decision-Making During Serious Illness in a Diverse Urban Palliative Care Population. Emory University (Atlanta); Project Director, Tammie Quest, MD, Project Chaplain, George Grant, ACPE
A diary study of 1140 chaplain-patient encounters demonstrated the value of chaplain-patient communication and revealed that more than half of chaplain visits focused on issues other than spiritual. The study also showed that conversations with patients were more likely to be about “practical matters” (family care, life review, medical care, work) than about “ultimate concerns” (expressed emotions, existential matters, spiritual/religious matters, physical symptoms).
Hospital Chaplaincy and Medical Outcomes at the End of Life. Dana Farber Cancer Institute (Boston):
Project Director, Tracy Balboni, MD, Project Chaplain, Angelika Zollfrank, BCC
The data from this study is a first step in furthering the understanding of how chaplaincy care influences patient well-being and medical decision making at the end of life.
Understanding Pediatric Chaplaincy in Crisis Situations, Children’s Mercy Hospital (Kansas City)
Project Director, John Lantos, MD, Project Chaplain, Dane Sommer, BCC
Researchers analyzed seven in-depth case studies that reveal how medical professionals utilize chaplains in the care of seriously ill children. They learned that most health professionals have little or no understanding of what chaplains do and that this has implications for patient and family care. Key findings showed that: tangible objects are very important (e.g., prayer shawls and teddy bears); physical interaction builds trust (e.g., eye contact).
Caregiver Outlook: An Evidence-Based Intervention for the Chaplain Toolkit. Duke University Medical Center (Durham, NC):Project Director, Karen Steinhauser. PhD, Project Chaplain, Annette Olsen, BCC
For the first time, researchers established that it is feasible for chaplains to use a standardized, low-cost phone-delivered intervention. This has important implications because the intervention is measurable, controllable and transferrable. Both religious and non-religious participants found conversations with the chaplain meaningful and without an agenda.
“What do I do” – Developing a Taxonomy of Chaplaincy Activities and Interventions for Spiritual Care in ICU Palliative Care. Advocate Charitable Foundation & Advocate Health Care (Chicago):
Project Director, Kevin Massey, BCC, Co-Principal Investigator, William Summerfelt, PhD
This study begins to explain how spiritual care is helpful by revealing a common language, list of activities, effects and outcomes for chaplains. The research showed that professional chaplains play a major role in helping patients express their wishes about end of life and advance care planning. The study generated 348 taxonomy items.
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