Predictors of ACP competency among Chaplains by Service Line

Abstract

Abstract Healthcare chaplains have key roles in palliative care including facilitating advance care planning (ACP). However, little is known about chaplains’ competency in ACP. We conducted an online survey with board-certified healthcare chaplains recruited from three major professional chaplains’ organizations. We explored correlates of chaplains’ competency in ACP facilitation among two groups of chaplains, general and special care (SC) chaplains (chaplains in oncology, intensive care, or palliative units) because SC chaplains are generally more involved in palliative care. The final sample included 481 chaplains with 89.8% reporting ACP as an important part of their work and 71.3% reporting to help patients complete advance directives. There was no significant difference in ACP competency between general chaplain group (n=240; M=39.61, SD=7.0) and SC chaplain group (n=241; M=40.65, SD=5.87). Hierarchical regression analyses revealed differences between the groups. General chaplains who practiced longer as a chaplain (b=1.02, p<.000), were more engaged in ACP facilitation (b=1.06, p<.05), had more positive attitude toward ACP (b=4.04, p<.000), and reported a higher level of participation in shared decision-making with other team members (b=.75, p<.000) were more competent in ACP facilitation. In the SC chaplain group, higher competency was associated with more positive attitude towards ACP (b=2.58, p <.05), and a higher level of participation in shared decision-making (b=1.05, p <.000). Overall, these findings suggest that healthcare chaplains, both general and special care, are competent and actively involved in ACP facilitation. Further systematic studies are warranted to examine the effects of chaplains facilitating ACP on patient and healthcare system outcomes.