Christian Hospitals Research Articles

Transformational Impact Rating System: a method to assess the impact potential of hospitals in low-resource settings

Background: Historically, many Christian mission hospitals were established by home churches from developed countries in their colonies. With countries gaining independence and missionary medical staff leaving these hospitals, the majority have closed. These hospitals provide critical assistance to communities that need their services the most, yet they often lack the financial and human resources needed to realize their full potential for community impact. Existing charity rating organizations rate few charities and lack transparency for donors, and limited resources exist to help volunteers find organizations that would benefit from their services the most. We propose a transparent Transformational Impact Rating System (TIRS) that can be used by funding agencies and volunteer directing agencies to assess the potential for transformational impact of any hospital anywhere in the world. Methods: Research to inform the rating system was conducted via a comprehensive review of existing charity rating organizations, in-depth interviews, and surveys. The rating system was developed by identifying, down-selecting, categorizing, and allocating weights to variables of importance. The rating system was then implemented via a custom-built website. Results: To receive a score, data is collected from the hospital and surveys of donors, volunteers, staff, patients, and the local community. Hospitals receive an overall score and scores in each of five categories: regional impact potential, financial health, operational performance, external relations, and volunteer experience. Conclusion: TIRS provides a proof-of-concept platform through which all hospitals in low-resource settings can make their impact potential visible to donors and volunteers. If TIRS (or modified similar tools) are used by those interested in helping mission hospitals, they will be more likely to adopt best practices, and invisible hospitals that are struggling in remote areas will be more likely to receive much-needed resources. The Christian community has a mandate to serve the poor and marginalized, resulting in a large number of Christian schools, colleges, and hospitals established across the globe. These establishments face increasing threats to their existence, and tools like TIRS can help direct declining funds and manpower to hospitals that have the highest potential for transformational impact.

Primary healthcare training in the Democratic Republic of the Congo.

Family medicine is a relatively new discipline in the Democratic of the Congo. It was developed under South-South and Churches Collaboration with the aim of responding in a cost-efficient manner to the crisis of health practitioners in mostly Christian and protestant hospitals based in rural areas in the Democratic Republic of the Congo.

Christian Women and the Development of Nascent Feminist Consciousness in Nineteenth-Century China

In 2010, Padma Anagol argued that the first modern feminists in India were Christian women, women such as Laxmibai Tilak and Pandita Ramabai. Using Anagol’s definition of feminism as “a theory and practice which presented a challenge to the subordination of women in society and attempted to redress the balance of power between the sexes,” this article shows how feminist consciousness was cultivated in Christian schools, churches, hospitals, and organizations in late-nineteenth-century China. Kwok Pui Lan pointed out in 1992 that Christians were the first women in China to band together to fight women’s oppression; however, like so many of the claims made about women in global Christianity, this one has not yet been fully appreciated by historians and missiologists. I show how mission schools gave girls access to new models of personhood and womanhood. Likewise, Christian scriptures, churches, and voluntary societies such as the WCTU and YWCA provided space to reflect on gender identity and activism. Through all these avenues, a modest version of Christian feminism was cultivated in China decades before the secular women’s movement began in 1900.

Christianity and Spirituality in Healthcare

According to the American Medical Association, ‘Health care is a fundamental human good because it affects our opportunity to pursue life goals, reduces our pain and suffering, helps prevent premature loss of life, and provides information needed to plan for our lives.’ Christianity is the world’s largest religion and most widely diffused of all faiths stemming from the life teachings of Jesus Christ. Religion, medicine, and healthcare have always been intertwined from history. Dating back throughout the Middle Ages and up to the French Revolution, physicians were often clergy. The first hospital in the West was started by a religious organization and staffed by religious orders. Researchers at the Mayo Clinic have concluded that, “Most studies have shown that religious involvement and spirituality are associated with better health outcomes, including greater longevity, coping skills, and health-related quality of life (even during terminal illness) and less anxiety, depression, and suicide. Several studies have shown that addressing the spiritual needs of the patient may enhance recovery from illness.” Jesus Christ in his teachings instructed his followers to heal the sick and since then the early church and Christians practiced practical charity that gave a basis to nursing homes and hospitals. Jews and Christians believed that human worth was predicated on the fact that each person was created in the image and likeness of God, which—for Christians—was directly stated in Matthew 25:40 “Whatever you do to the least of these, you do to me.” In recent times, when people are faced with many health issues that medical professionals do not seem to have an answer for, looking outside of the traditional health setting and up to a divine power for healing has been on the rise. A 2018 survey of American physicians and patients suggests that about 64% of physicians believe in the existence of God or a higher power, and more than 90% of patients claimed the same. Jesus in his teachings emphasized the need of treating every human with love, which is why Christian hospitals were established with the main aim of practicing the teachings of Jesus and alleviating suffering of the sick. It is also noted that there is an increase in modern western medicine with the importance of patient spirituality in treatment and healing which must be considered by healthcare professionals while providing care. As for physicians who are rooted in the Christian faith, they would provide care to their patients keeping in mind that they are made in the image of God. Since healing is an art which is personal and human, there is only a limited amount of human intervention which can contribute to its success. When modern medicine and Christian faith is intertwined in patient care, the provider and patient feel a sense of spiritual calmness that contribute to the total healing journey

Health systems strengthening through the faith-based sector: Critical analysis of facilitators and inhibitors of nationalization of mission hospitals in India

Introduction: The extensive network of Christian mission hospitals in India faced an abrupt loss of financing and supply of medical missionaries during and after independence in 1947. Many of the remaining went on to become indigenously owned Christian hospitals and prestigious medical colleges that maintained the heart for the poor and for spiritual care that was inspired by their founders. The aim of this critical analysis is to explore the literature to understand what helped these hospitals survive when others failed and lessons that can be learned to help direct future investment and programs for health systems strengthening. Methods: A literature review was conducted utilizing PubMed and Google Scholar and combinations of keywords (mission, hospital, India, independence, indigenization, sustainability, history, health system). The initial list of 785 articles was filtered down to 28 that specifically address the research questions. Excerpts from these articles were annotated, coded, and evaluated for core themes. Results: The following core themes arose as factors that contributed to their success: 1) shared mission, vision, and core values, 2) early emphasis on medical education, especially for women, 3) local champions, patrons, and governance, 4) strong community linkages, 5) strategic collaborations, and 6) healthy systems and infrastructure. Recommendations: Most international investment in health systems strengthening has focused on short- and medium-term health outcome goals. While these have certainly saved the lives of millions, we must also consider what will be required to foster healthy healthcare systems. Long-term investment in building committed healthcare leaders and healthy institutions is challenging, but necessary, to meet long-term health goals. Faith-based hospitals are key allies in this endeavor.

MODELLING THE RISK FACTORS FOR BIRTH WEIGHT IN TWIN GESTATIONS: A QUANTILE REGRESSION APPROACH.

Birth weight is used as a proxy for the general health condition of newborns. Low birth weight leads to adverse events and its effects on child growth are both short- and long-term. Low birth weight babies are more common in twin gestations. The aim of this study was to assess the effects of maternal and socio-demographic risk factors at various quantiles of the birth weight distribution for twin gestations using quantile regression, a robust semi-parametric technique. Birth records of multiple pregnancies from between 1991 and 2005 were identified retrospectively from the birth registry of the Christian Medical College and hospitals in Vellore, India. A total of 1304 twin pregnancies were included in the analysis. Demographic and clinical characteristics of the mothers were analysed. The mean gestational age of the twins was 36 weeks with 51% having preterm labour. As expected, the examined risk factors showed different effects at different parts of the birth weight distribution. Gestational age, chroniocity, gravida and child's sex had significant effects in all quantiles. Interestingly, mother's age had no significant effect at any part of the birth weight distribution, but both maternal and paternal education had huge impacts in the lower quantiles (10th and 25th), which were underestimated by the ordinary least squares (OLS) estimates. The study shows that quantile regression is a useful method for risk factor analysis and the exploration of the differential effects of covariates on an outcome, and exposes how OLS estimates underestimate and overestimate the effects of risk factors at different parts of the birth weight distribution.

PRIME Partnerships in International Medical Education - Restoring a Christian ethos to medical education worldwide

Modern medicine has developed from an essentially Christian world-view and in Western countries has been greatly influenced by the Christian tradition of hospitality and caring for the sick. However, during the 20th century, medical education became increasingly secularised and focussed on the bio-physical model of disease, losing sight of a holistic view of the person that includes awareness of a spiritual dimension. Former Communist countries in particular have little recent tradition of caring, and medical education there tends to be characterised by poor role-models and out-dated didactic teaching. In the resource poor countries of the global South there are many Christian hospitals and clinics but often a lack of experienced medical teachers. Partnerships in International Medical Education (PRIME)’s vision and mission is to support health-care education worldwide to restore a Christian-based holistic approach to patients, and act as a resource where needed, tailoring medical educational programmes to meet the needs of overseas partners (or colleagues in the NHS). Using interactive leaner-centred and problem- based educational methods, PRIME tutors (all experienced and qualified Christian medical educators) seek to model patient-centred care by using learner-centred teaching, valuing each person as a bearer of the image of God. Most of PRIME’s teaching involves the doctor-patient relationship, communication skills, compassion, ethics and professionalism, often based around particular clinical scenarios to suit the learners. Small teams of voluntary tutors visiting partner institutions and colleagues for a few weeks a year can have a surprisingly large impact, as those grasping the vision become advocates for positive change in their own situations. Training of trainers and teachers in learner-centred, androgogic methodology to build capacity and sustainability is also a major part of the work.

A Development of Byzantine Christian Charities during the 4th-7th Centuries and the Birth of the Hospital

This study aims to examine the beginning and the development of Christian Charities during the 4(th)-6(th) centuries which would eventually result in the birth of the hospital in modern sense in the first half of the 7(th) century. For this purpose, I looked carefully into various primary sources concerning the early Christian institutions for the poor and the sick. Above all, it's proper to note that the first xenodocheion where hospitality was combined with a systematic caring, is concerned with the Trinitarian debate of the 4(th) century. In 356, Eustathios, one of the leaders of homoiousios group, established xenodocheion to care for the sick and the lepers in Sebaste of Armenia, whereas his opponent Aetios, doctor and leader of the heteroousios party, was reckoned to have combined the medical treatment with his clerical activities. Then, Basil of Caesarea, disciple of Eustathios of Sebaste, also founded in 372 a magnificent benevolent complex named 'Basileias' after its founder. I scrupulously analysed several contemporary materials mentioning the charitable institution of Caesarea which was called alternatively katagogia, ptochotropheion, xenodocheion. John Chrysostome also founded several nosokomeia in Constantinople at the end of the 4(th) century and the beginning of the 5(th) century. Apparently, the contemporary sources mention that doctors existed for these Charities, but there is no sufficient proof that these 'Christian Hospitals,' Basileias or nosokomeia of Constantinople were hospitals in modern sense. Imperial constitutions began to mention ptochotropheion, xenodocheion and orphanotropheion since the second half of the 5(th) century and then some Justinian laws evoked nosokomium, brephotrophia, gerontocomia. These laws reveal that 'Christian Hospitals' were well clarified and deeply rooted in Byzantine society already in these periods. And then, new benevolent institutions emerged in the 6(th) century: nosokomeia for a specific class and lochokomeia for maternity. In addition, one of the important functions of Sampson Xenon was, according to Novel 59, to hold a funeral service for the people of Constantinople. Nevertheless, there is no sufficient literary material that could demonstrate the existence of a hospital in modern sense. The first hospital where outpatient service, hospitalization and surgery were confirmed was Sampson Xenon in the first half of the 7th century, figured in the tale of Stephanos of the The Miracles of St. Artemios. Why was the early Byzantine literary so reticent as to write the medical activities in the Christian Charities? It's because Christian innovation didn't rest on the medical treatment but caring for the poor and the sick, depending on the word of Mt. 25.35-36. In this meaning, I'd like to say that the Early Byzantine history of Christian Charities or 'Christian Hospitals' consists of only a footnote of the verse.

Dalit Christians Struggle for Justice in the Indian Sub-continent

In the India-Subcontinent the women s liberation, ecological liberation; and with the specific influence of the black theology and the liberation theology, Dalit theology became a possibility in its particular socio-economic, political and religious context. Human tendencies seem to be universally common and oppression of the weak has been a ubiquitous dynamic showing different faces in different continents and countries. Dalit theology in India stands out with its undergirding principle of pathos, and hermeneutical principle of reading the scripture with the eyes of the poor and oppressed. Atrocities on the Dalits in Andhra Pradesh are invariably committed by the people belonging to the dominant Reddy caste. News papers carry news of incessant heinous crimes the Reddys commit against the Dalits. Our former Chief Minister late Dr. Y. S. Rajashekar Reddy, who belonged to the same caste, but Christian by faith has moved a motion in the State Assembly to consider the Dalit Christians for the Scheduled Caste reservations on par with the Dalits of other religious professions. The same has been sent to the Central government for further consideration. Dr. Reddy has also established what he called as Andhra Pradesh State Christian Minority Finance Corporation. It is in and through this Corporation Dalit Christians are aided in their education, vocational training and employment. The Corporation also takes up issues concerning Christians with the State and the Central government. It also helps in reviving the Christian hospitals, educational institutions, reconstruction of church buildings, purchase of burial grounds, taking Christians on a Holy Land tour on a subsidized tariff. This Corporation has become a ray of hope in the lives of the Dalit Christians of the state of Andhra Pradesh. Church Heads and Christians leaders and the respective state Christian Councils need to pressurize the Chief Ministers to establish such State Christian Minority Finance Corporations catering justice to the Dalits Christians in the Indian Sub- Continent. Mean while the struggle to consider the Dalit Christians for the Scheduled Caste reservations continues in the national scenario.

International comparison study on the primary concerns of terminally ill cancer patients in short-term life review interviews among Japanese, Koreans, and Americans

The aim of this study was to investigate the primary concerns of terminally ill cancer patients in a Short-Term Life Review among Japanese, Koreans, and Americans to develop intervention programs to be tailored to patients in other countries. Twenty Japanese, 16 Korean, and 7 American terminally ill cancer patients who were in the hospice wards of general Christian hospitals in each country participated in this study. Medical staff members (nurses, social workers, clinical psychologists) performed Short-Term Life Review Interviews with each patient. Patients reviewed their lives in the first session, the interviewers made simple albums for each patient in the week following the first session, and patients and interviewers then confirmed the contents of the album. The treatment period was 1 week. Measurement instruments included the Functional Assessment Chronic Illness Therapy-Spiritual (FACIT-Sp) and the Hospital Anxiety and Depression Scale (HADS). The contents of each interview session were transcribed, and correspondence analysis and a significance test were conducted on these data to select characteristic words or phrases. Using the FACIT-Sp scores, the following concerns were chosen, in descending order of frequency. In Japan, primary concerns consisted of such ideas as "good human relationships and transcendence," "achievements and satisfaction," "good memories and important things," and "bitter memories." In Korea, "religious life," "right behavior for living," "strong consideration for children and will," and "life for living" were primary concerns. In the United States, "love, pride, will to children," "good, sweet memories," and "regret and a feeling of loss" were primary concerns. We clarify the differences among the primary concerns from the Short-Term Life Reviews, arguing that we can improve the spiritual well-being of terminally ill cancer patients by focusing on the primary concerns within each country.

Cultural and Health Management Practices of the Garo Community of Bangladesh: A Case Study of the Garos of Greater Mymensingh District

An extensive survey study was carried out on different aspects of health management practices of the Garo communities in Bangladesh to assess their actual present health status. The study was carried out on 1205 respondents out of 40,173 total Garo people of the study area of greater Mymensingh district. The study revealed that Garos enjoy a better health status than the common Bengali community. It was also observed that traditional cultural practices have great influence on the health management of the Garos. Many of the Garos think that diseases result from the dissatisfaction of the gods and goddesses or curses of the evil spirits. Thus they sacrifice animals to please the spirits to get relief of their diseases. Almost all the Garos use water from tube well (53.69%) or puller pump (44.81%) for drinking, bathing and cleaning purposes. Every family has a latrine. Almost everybody is concerned about regular dental care and half of the Garos are concerned about family planning. Garos eat a wider variety of foods including numerous natural plants as vegetables, some of which have medicinal values. Traditionally Garos are fond of drinking wine, prepared from boiled rice. The study also revealed that the Garos are generally less attacked by diseases than the common Bengali people. This may be attributed to their better living environment, food habits, cleanliness, hard work in the fields and sufficient rest after work and, after all, consciousness about health and diseases. But yet, diseases are quite common in this community; the most common one being Malaria. Most of the Garos take treatment from their traditional health practitioners although treatment of modern Allopathic system is available in the local Christian hospitals. About 55.68% of the Garos expressed their firm faith on their traditional treatment systems. In spite of some superstitions about diseases and health, the overall health status of the Garos is comparatively better than the majority of the mainland Bengali community. Key Words: Garo community, Garo culture, Health management practices, Traditional healers    doi:10.3329/sjps.v1i1.1783 S. J. Pharm. Sci. 1(1&2): 29-37

A comparison of cisplatin/paclitaxel and carboplatin/paclitaxel in stage IVB, recurrent or persistent cervical cancer

Cisplatin-based combination therapy produces higher response rates and improved survival, in comparison to single-agent cisplatin in the treatment of cervical cancer. Cisplatin and paclitaxel (PT) requires a prolonged infusion and is less convenient and more toxic than the combination of carboplatin and paclitaxel (CT) leading to more widespread use of CT. The objective of this study was to compare response rate and survival in patients with cervical cancer treated with PT or CT. A retrospective search of databases at the University of Oklahoma, Washington University-Barnes Jewish Christian Hospitals, Johns Hopkins University, and University of Alabama at Birmingham identified patients with stage IVB, recurrent or persistent cervical cancer who were treated with PT or CT. A total of 62 patients were identified. 14 were treated with PT and 48 with CT. There were no statistical differences between the groups in terms of demographics, prior radiation therapy, or median number of cycles. There was a trend toward a larger number of patients in the CT arm having received prior cisplatin/radiation (p=0.07). Objective responses occurred in 29% of patients receiving PT vs. 53% of patients receiving CT. With a median follow-up of 9 months, survival was not different with a median survival of 14 and 11 months, respectively. In this retrospective evaluation, CT compares favorably with PT and demonstrates a superior overall response rate. Because of its ease of administration and improved toxicity profile, CT should be considered in the treatment of advanced, recurrent or progressive cervical cancer.

A Clinical Prediction Rule for the Severe Acute Respiratory Syndrome

Letters1 February 2005A Clinical Prediction Rule for the Severe Acute Respiratory SyndromeFREETimothy H. Rainer, MD, Irene O.L. Wong, MPhil, MMedSc, and Gabriel M. Leung, MD, MPHTimothy H. Rainer, MDFrom Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, and University of Hong Kong, Pokfulam, Hong Kong, China.Search for more papers by this author, Irene O.L. Wong, MPhil, MMedScFrom Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, and University of Hong Kong, Pokfulam, Hong Kong, China.Search for more papers by this author, and Gabriel M. Leung, MD, MPHFrom Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, and University of Hong Kong, Pokfulam, Hong Kong, China.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-3-200502010-00020 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Ma and colleagues' results after applying our clinical prediction rule confirm the generalizability of the algorithm beyond Hong Kong to another urban population affected by SARS. This satisfies the call by the U.S. Centers for Disease Control and Prevention to externally validate our decision rule to assess its clinical effectiveness for potential future outbreaks (1).For cross-validation purposes, we applied the Taiwanese rule (2), previously published by Ma's group, to our sample: 2649 emergency department attendees at the Prince of Wales and United Christian Hospitals, which provided care for the 2 largest outbreak clusters in Hong Kong. The Table shows the performance indices associated with both the Hong Kong and Taiwanese decision rules. In the base-case analysis, Ma and colleagues' symptom scoring system achieved a sensitivity of 0.513 and a specificity of 0.583, with an area under the receiver-operating characteristic curve of 0.57; for the clinical scoring system, these values were 0.481, 0.764, and 0.65, respectively. If this rule were applied during a large-scale outbreak, such a low sensitivity and similarly suboptimal performance indices would be unacceptable, given the public health risk associated with false underdiagnosis and potential community transmission by the missed patients.Table. Performance Indices for 2 Clinical Prediction Rules as Applied to the Hong Kong SampleOne caveat bears special mention. The “cough” variable in the Taiwanese rule is time-dependent. Specifically, it does not register a score of −2 if cough developed after the onset of fever, that is, only those who had a cough before becoming febrile or when they became febrile were counted. Therefore, as a sensitivity analysis, we randomly reassigned (through 100 iterations) those in the Hong Kong sample who reported the symptom of “cough” to “no cough,” by varying degrees. In our sample, 54.7% were originally recorded as having a cough. To test for the robustness of our findings by taking this caveat in symptom definition into account, we lowered this proportion to 0.1 to 0.4 by simulation, as described. Although sensitivity improved when progressively fewer patients were recorded as having a cough, specificity was lowered correspondingly and the area under the receiver-operating characteristic curve did not change appreciably. Thus, it is unlikely that such variation in the definition of cough is solely responsible for the lack of generalizability of the Taiwanese decision rule.In addition, Ma and colleagues commented that some of our patients might have acquired SARS after hospital admission. This is possible but unlikely. Almost all patients had a strong contact history and radiographic changes before admission, but many did not have a temperature of 38 °C or greater at admission.In sum, we conclude that our clinical prediction rule is superior and has excellent external validity. Therefore, it can and should be adopted as the standard to aid health authorities worldwide in planning for a possible return of SARS, especially in regions without adequate access to laboratory facilities or rapid diagnostic testing.Timothy H. Rainer, MDPrince of Wales Hospital, Chinese University of Hong Kong; Shatin, Hong Kong, ChinaIrene O.L. Wong, MPhil, MMedScGabriel M. Leung, MD, MPHUniversity of Hong Kong; Pokfulam, Hong Kong, China

Should We Be Concerned About the Content of Mission Statements for Christian Hospitals?

Should We Be Concerned About the Content of Mission Statements for Christian Hospitals?

Ethics committees in Germany: an empirical survey of Christian hospitals.

Ethics committees in Germany: an empirical survey of Christian hospitals.

Should we be concerned about the content of mission statements for Christian hospitals?

Should we be concerned about the content of mission statements for Christian hospitals?

Practical Hospital Pharmacy Management: Management Strategies and Methods

This review deals with the practical management of hospital pharmacies based on experience in Indian Christian hospitals with capacities ranging from about 30 to 500 beds. However the standards of pharmacy management should not depend on size; they should be kept under review and improved as staff and financial considerations allow.

Secularisatie en verzuiling in de Belgische politiek

Sociological research in three Catholic «pillar» organizations (the Catholic school system, the Christian hospitals and the Catholic University) indicates that secularization is not followed by a «de-pillarization» or crumbling of the Catholic pillar. Our explanation suggests a process of secularization within the Catholic organizations, with as main components : the development of a social-cultural christianity - which may be considered a secular surrogate for church-religion -, and professionalization by which the christian organizations provide a milieu which ensures job security and social advancement for its loyal members. Thanks to its informal and formal ties with the Christian pillar organizations, the CVP acts on both components, by stressing a specific identity and by defining the interests of the pillar organizations. This explanation may indicate some major aspects of the ties between sociological Catholics and «their» political party - a bond which is certainly not being affected by the secularization processes, rather the contrary is occurring.