Role Of Chaplain Research Articles

Health Care Chaplains and their Role on Institutional Ethics Committees: An Australia Study

This paper presents the results of the largest Australian pastoral study concerning the perceptions of health care chaplains about their involvement on hospital research ethics committees (also known in some contexts as institutional ethics committees). Survey results from over 300 Australian health care chaplains indicated that nearly 90% of chaplains believed there was merit in chaplains serving on hospital research ethics committees, yet only a minority (22.7%) had ever participated on such committees. Data from in-depth interviews is also presented exploring the reasons for the lack of participation and the varying opinions regarding the role, appropriateness, and value of chaplains on ethics committees. Some implications of this study with respect to chaplaincy, hospital research ethics committees, health care institutions, ecclesiastical institutions, and government responsibilities are discussed.

Communication Dynamics in Hospice Teams: Understanding the Role of the Chaplain in Interdisciplinary Team Collaboration

Hospice chaplains provide a specific expertise to patient and family care, however, individual roles and responsibilities that facilitate the interdisciplinary team environment are less well known. The primary aim of this study was to investigate how hospice chaplains perceive their role in interdisciplinary team meetings and to what extent hospice chaplains share common experiences within the interdisciplinary team approach in hospice. Hospice chaplains within a 10-state region participated in a 39-item phone survey about professional roles, group roles, and structural characteristics that influence their ability to participate in interdisciplinary collaboration. Findings revealed that professional role conflict is experienced, primarily with social workers. Informal group task and maintenance roles included team spiritual care advisor and conflict manager, and structural characteristics consisted of extracurricular communication outside of the organization. Although chaplains foster interdisciplinary collaboration within the hospice team, future research needs to address improvements to the chaplain's role within the interdisciplinary team process.

Lost in Translation: The Chaplain's Role in Health Care

Lost in Translation:The Chaplain's Role in Health Care Raymond de Vries (bio), Nancy Berlinger (bio), and Wendy Cadge (bio) Chaplains often describe their work in health care as "translation" between the world of the patient and the world of hospital medicine. Translators usually work with texts, interpreters with words. However, when chaplains use this metaphor, it describes something other than a discrete task associated with the meaning of words. While medical professionals focus on patients' medical conditions, chaplains seek to read the whole person, asking questions about what people's lives are like outside of the hospital, what they care about most, and where they find joy and support in the world. Chaplains offer a supportive presence that serves to remind patients and caregivers that people are more than just their medical conditions or their current collection of concerns. Some chaplains are skilled at translating patients' experiences and sources of meaning in real time, allowing medical teams to better understand the person they are treating. "Translation" is also defined as metamorphosis. Chaplains [End Page 23] provide this sort of translation when they are alone with patients, listening to their deepest concerns, helping them redefine their lives. Unlike a professional interpreter, who helps patients and clinicians communicate when they do not share a common language, the chaplain is not just a conveyor of the spoken words of others. A patient, family member, nurse, or physician may seek out the chaplain for help in translating a situation: Is the family in denial? Is the team giving up? Is the patient ready to go home, like her husband says, or ready to rest, like she says? Ironically, chaplains-skilled at mediating between patients and hospital staff-often have no one they can rely on to advocate for them at budget time, no one who can "translate" the tangible benefits chaplains provide to patients, families, and staff into terms hospital administrators can understand. The Professional Chaplaincy and Health Care Quality Improvement research project was initiated, in part, in response to this dilemma: If chaplains wish to be recognized as a health care profession, they need to be able to describe, to themselves and to others, what constitutes "quality" in their area of patient care. Like other health care professionals, they need to specify how their profession and their day-to-day work in the hospital contribute to the ongoing task of quality improvement in health care. This is no easy task. The work that chaplains do is difficult to measure in conventional QI terms: the precise duties of their job are unspecified, and chaplains often find themselves improvising to meet the needs of patients and caregivers. In this situation, how can chaplains define their role in improving health care? External perceptions of chaplains and chaplaincy also complicate this translational task: is chaplaincy best understood as a specialized form of religious ministry, in-but not of-the health care setting? Or is it truly a health care profession, and if so, what is the nature of the health care service that chaplains provide, and how is it relevant to patients' health care needs and their treatment? Is it, in some way, both of these? Without attention to these broader sociological questions, it is difficult for chaplains to see themselves as a "professionalizing profession," and to make the special nature of their work understood to the administrators who must make decisions about investing in services that have no reimbursement code. Raymond de Vries and Wendy Cadge, two of the authors of this essay, were invited by project codirector Nancy Berlinger, the third author, to participate in this project as sociologists who would observe, reflect, and offer a series of thinking points about the profession and future of hospital chaplaincy. De Vries comes to the project as a sociologist of bioethics (another occupation struggling with its identity and place in worlds of medicine and science) and with expertise in the sociology of culture and the professions. Cadge is a sociologist of religion who studies, among other things, the formal and informal presence of religion and spirituality in hospitals. The three of us offer our thinking in the spirit of continued conversation and with deep respect...

Military Chaplaincy in International Operations: A Comparison of Two Different Traditions

This article examines the role of military chaplains who accompany soldiers on international military and peace-keeping operations, such as those in Iraq, Afghanistan, Kosovo, and Bosnia Herzegovina. It compares and contrasts the two principal traditions of military chaplaincy in the international field—chaplains within the military structure (as in the UK) and parish-based chaplains who remain outside the military (as in Germany). The authors examine the potential conflict between the religious vocation of military chaplains and their role in military operations, which can be particularly contentious from an ethical viewpoint. Interviews with chaplains from both countries provide a unique insight into their experiences.

Spirituality and secularization: nursing and the sociology of religion

The concept of spirituality is much discussed in the UK nursing literature, despite the fact that Britain is one of the most secular countries in the world, and steadily becoming more so. Here, I pose the following question: given this increasing secularization, what accounts for the current interest in spirituality among UK nurses? The literature on spirituality in nursing has blossomed in the last 10 years, and various attempts have been made to define 'spirituality', 'spiritual need' and 'spiritual care'. Most definitions distinguish between 'spirituality' and 'religion', acknowledging that the latter is more institutional, and theologically more restrictive, than the former; and they suggest that spirituality is universal, something which (unlike religion) all human beings share. I draw on the sociology of religion - neglected, for the most part, in the nursing literature - to establish two main points. Firstly, that the UK and the USA are at opposite ends of the religion/secularity spectrum, implying that it is a mistake to assimilate USA and UK sources. Secondly, that the concept of spirituality, as currently understood, is of very recent origin, and is still 'under construction', having become separated from its associations with Christian piety and mysticism only since the 1980s. The extension of spirituality into secular domains is part of a professionalization project in nursing, a claim to jurisdiction over a newly invented sphere of work. For the time being, it remains an academic project (in the UK) as it is not one with which many clinicians identify. Relevance to clinical practice. What counts as 'spiritual need' or 'spiritual care' may not be the same in both countries, and UK clinicians are unlikely to welcome the role of surrogate chaplain, which their USA colleagues are apparently willing to embrace.

Referrals to chaplains: The role of religion and spirituality in healthcare settings

Given the increasing importance of understanding how healthcare workers interact with the principal person designated to meet patients’ spiritual needs— the chaplain— the current study provides an inter-disciplinary perspective of the role of chaplains (and spirituality) in patients’ emotional, physical, and spiritual health. The study surveyed a randomly selected national sample of hospital directors in four disciplines: medicine (n = 278), nursing (n = 230), social services (n = 229), and pastoral care (n = 470). Participants rated the importance of referring patients to chaplains for four different areas: pain/depression, anxiety/anger, treatment issues, and loss/death/meaning. Results revealed significant differences in referral patterns for type of hospital, professional discipline, the hospital's religious affiliation, and self-reported spirituality. Results are discussed in relation to historical views of spirituality and religion within the different disciplines.

Spirituality Training for Palliative Care Fellows

Spirituality is a major domain of palliative medicine training. No data exist on how it is taught, nor is there a consensus about the content or methods of such education. We surveyed palliative medicine fellowship directors in the United States to learn how they teach spirituality, who does the teaching, and what they teach. A PubMed (<www.pubmed.gov>) search using the terms "spirituality" and "medical education" was completed. Thirty-two articles outlined spirituality education content and methods in medical schools and residency programs. From these articles, a survey on spirituality education in palliative medicine fellowship training was prepared, pilot-tested, revised, and then distributed by e-mail in June 2004 to the 48 U.S. palliative medicine fellowship directors listed on the American Board of Hospice and Palliative Medicine (AAHPM) website, but excluding the three fellowship programs represented by the authors. Follow-up requests were sent by email twice during the 6-week collection period. The Institutional Review Board at the Medical College of Wisconsin approved the study. Fourteen fellowship directors completed the survey (29% of all programs; 42% of those currently teaching fellows as indicated on the AAHPM website). All programs indicated they taught "spirituality"; 12 of 14 had separate programs for teaching spirituality and 2 of 14 reported they taught spirituality to their fellows but not as a distinct, separate program. All respondents taught the definitions of spirituality and religion, common spiritual issues faced by patients at end of life (which was not defined further), and the role of chaplains and clergy. Chaplains provided spirituality education in all of the responding programs, but other team members were frequently involved. The most common formats for education in the domains of knowledge and attitudes were small group discussion, lecture, and self-study. Small group discussion, supervision, and shadowing a chaplain or other professional were the most common methods used for skills. Faculty written or oral evaluations of fellows were the most common forms of evaluation, with little evidence of more robust assessment methods, such as structured role-play (none of the programs surveyed). Palliative medicine fellowship programs generally agree on the content of training on spirituality, but have not incorporated robust educational and evaluation methods to ensure that fellows have obtained the desired attitudes, knowledge, and skills to meet the Initial Voluntary Program Standards for Residency Education in Palliative Medicine of the American Board of Hospice and Palliative Medicine. Based on the survey data and results from the literature review, broad recommendations are made to enhance spirituality education.

Meditation, Social Change, and Undergraduate Education

This article argues that meditation guided by a competent teacher can be a positive influence in contemporary American society and even a force for progressive social change. A number of critical issues requiring further study are identified, including the need for a better understanding of meditation from the perspective of developmental psychology and of the relation between meditation and psychotherapy. The article proposes that American educational institutions can benefit from a deeper appreciation of the contemplative dimension of life. Special attention is given to how the American undergraduate college can provide students with opportunities to learn about and experience various forms of meditation. The role of teachers, chaplains, psychological counselors, and health care professionals in introducing meditation to students is discussed.

Meditation, Social Change, and Undergraduate Education

This article argues that meditation guided by a competent teacher can be a positive influence in contemporary American society and even a force for progressive social change. A number of critical issues requiring further study are identified, including the need for a better understanding of meditation from the perspective of developmental psychology and of the relation between meditation and psychotherapy. The article proposes that American educational institutions can benefit from a deeper appreciation of the contemplative dimension of life. Special attention is given to how the American undergraduate college can provide students with opportunities to learn about and experience various forms of meditation. The role of teachers, chaplains, psychological counselors, and health care professionals in introducing meditation to students is discussed.

Focus: The Chaplain's Role in Organ Donation

Focus: The Chaplain's Role in Organ Donation

Hope for the future.

SINCE THE BIRTH of the NHS in 1948, the traditional role of hospital chaplains has included some, and in a few cases all, of the following.

Engaging with the Religion of Those Who Do Not Attend Public Worship

This religion can be explored in terms of Experiences, Beliefs, and Practices. ‘Experiences’ includes passing through crisis; meeting the dead, and extra-sensory perception; and relational consciousness. ‘Beliefs’ explore the roles of induction and intuition; the continuing quest; and life after death. ‘Practices’ are articulated as the golden rule; the common round; and prayer. This paper defines religion, expounds the work of some researchers, suggests how a church might adopt the role of chaplain to this religion, and hints at a theology that might under-gird such work. It suggests that pluriformity within the church’s own Trinitarian tradition enables it to operate within whichever model is most appropriate for the people with whom it is dealing.

A prospective study of the roles, responsibilities and stresses of chaplains working within a hospice

Spiritual care is an integral part of palliative care and if asked, most members of a palliative care team would state they address spiritual issues. The majority of hospices have support from a chaplain. This study was to determine the roles of chaplains within hospices and to look at their levels of stress. A questionnaire containing both open and closed questions was sent to chaplains working within hospices in the UK. The questionnaire enquired about number of sessions, specific roles of chaplain, whether they were members of the multidisciplinary team and their sources of internal support. Stress was measured on a 10-point Likert scale and the GHQ12. One hundred and fifteen questionnaires were returned, with a 72% response rate. The majority (62%) defined their denomination as Church of England and Free Church (24%); 71% of respondents had parish commitments in addition to their hospice role. Roles were predominantly defined as spiritual care of patients and staff (95%) and bereavement support of relatives (76%) and 75% regularly attended the multidisciplinary meetings. Senior medical and nursing staff and other chaplains were perceived as providing most support. Median Likert score for stressfulness was 5, and 23% scored at or above the threshold on the GHQ12 for identifiable psychological morbidity. Clear role definition was associated with less perceived stress whereas the provision of bereavement support was associated with statistically significant increased perceived stress. The role of a chaplain within a hospice is varied and this study suggests that the provision of training and formal support is to be recommended.

The Chaplain's Role in an Institution for the Mentally Retarded

SUMMARY A chaplain in an institute for persons with mental retardation faces challenges in pastoral relationships, worship, religious education, working with a team of clinicians, and theological reflection. The minister must think creatively and tailor his or her responses directly to the needs of the person with mental retardation. Taking into account the needs of each individual, the minister must communicate through physical interaction, repetition of themes, and a great deal of participation on the part of the person with mental retardation. Out of these concrete pastoral experiences, theology can be developed that uses the experience of parents of those with mental retardation. This theology can question the traditional divide between those with mental retardation and the “normal” people.

Residents from five training programs report improvements in knowledge, attitudes and skills after a rotation with a hospice program.

The faculty of the Center for Palliative Studies teach residents from 5 different primary care residency training programs who rotate at San Diego Hospice: 3 in Internal Medicine, 2 in Family Medicine. Residents participate in the care of patients in the inpatient care setting and make joint home visits with physicians and other team members. A series of 4 lectures on end-of-life care is given on Tuesday mornings: management of pain, other symptoms, interdisciplinary roles of chaplains, social workers, nurses, and grief/bereavement are discussed. In addition, there is a Tuesday noon conference that follows a journal club format. Because of scheduling, residents from some programs are not able to attend all lectures and conferences. A 27-item self-assessment evaluation tool was developed for administration to residents before and after their experience. A total of 65 evaluations for residents rotating in academic year 1997-98 and 1998-1999 were collated and analyzed. When evaluated as a whole, residents noted significant improvements in their ability to assess and treat symptoms, to tell patient/family about the dying process and to care for dying patients at home (range in improvement from 26% to 67%, p < 0.05 using paired t-test). About half of the residents perceived that the content was not available elsewhere in their training. We conclude that a single hospice rotation can effectively contribute to resident education in multiple programs.

The Father Mulcahy Effect: The Role of the Chaplain in the Treatment of the Burn Patient

The Father Mulcahy Effect: The Role of the Chaplain in the Treatment of the Burn Patient

The role of spirituality in patient care: incorporating spirituality training into medical school curriculum.

To answer the call for the implementation of spirituality into medical school curriculum,(1) UMKC-School of Medicine has incorporated experiential spirituality instruction into the third year of a six-year combined BA-MD degree program. The multifaceted objective of the program is to (1) expand students' conceptualization of the patient as person to include dimensions of spiritual beliefs and needs, (2) develop an understanding of how patients' spiritual belief systems impact their health, (3) recognize how the student's spiritual beliefs impact his or her practice of medicine, and (4) highlight the value of the chaplain as a member of the health care team. With increased understanding of the role spirituality plays in healing as well as the spiritual services available to patients, students will be able to serve the needs of their patients. To accomplish this objective, students participate in lectures on spirituality, small-group activities focusing on skills such as taking/crafting spiritual histories, and an on-call experience with a hospital chaplain. During the oncall experience, students shadow a chaplain for approximately six hours. The experience includes discussing philosophies of spirituality and medicine with the chaplain, rounding with the chaplain, visiting and praying with patients when requested, comforting family members, and assisting with advance directive discussions and paperwork. After completing the experience, the students are required to write a reflective essay examining the following components: (1) the interaction between the chaplain and other members of the health care team, (2) the utilization of alternative interview and history taking methods, (3) the connection between spirituality and illness as illustrated through patient encounters, and (4) the insights gained from the experience that can be applied to the practice of medicine. The writing of one's spiritual history and the on-call experience were integrated into a new portion of the curriculum. The components were initially met with some reticence. In the beginning, students had difficulty distinguishing spirituality from religion and were concerned that the curriculum would take away from their study of "real medicine." To ease concerns regarding the spiritual history, the course director modeled the objectives by sharing her own spiritual journey. Participation in the on-call experience substantially changed students' negative attitudes toward the curriculum. Essays revealed that the on-call experience had greatly impacted their view of the chaplain as well as their practice of medicine. Specifically, students demonstrated an understanding of the role of spirituality in healing, identified key components of the chaplain role in the hospital setting, shared ways in which they would utilize chaplains in the future, and discovered personal struggles. Crafting one's spiritual history, the on-call experience, and essays will continue to be a required part of the third-year curriculum. Modifications include adding the option of constructing one's own advance directive and striving for increased diversity of spiritual perspectives. The data provided in the essays and course evaluations will be utilized in several ways to determine the success of the curriculum and to answer critical research questions in the areas of spirituality and medical education.

Easing the Passage: The Chaplain’s View of Prison Hospice

This article looks at end-of-life care in corrections through theministry of three working chaplains: Rev. Keith Knauf, director of pastoral care services, California Medical Facility, Vacaville Rev. John Moyna, chaplain at Coxsackie Regional Medical Unit at Coxsackie Correctional Facility and pastor of St. Mary’s Church, Coxsackie, New York Rev. Judith Steele, chaplain at the Oregon State Penitentiary, Salem, where she coordinates the inmate volunteer program Although all three are Christian-based clergy, their ministry prescindsdenomination as they discuss the role of chaplains in interdisciplinaryteams, their liaison with families and volunteers, bereavement, and theuniversality of passage, even in corrections.

Incorporating spirituality into the delivery of dialysis care: one team's perspective.

The importance of spirituality and organized religion in coping with chronic kidney disease (CKD) and other medical illnesses has been cited in the literature in recent years. This article describes how one dialysis unit recognized the importance of spiritual resources for patients and incorporated the role of chaplain into its interdisciplinary health care team. The resulting enhancement of team functioning and sensitivity to patients' spiritual needs is discussed.

Understanding the chaplain's role in an age of weapons of mass destruction.

The possibility and/or use of weapons of mass destruction (WMD), in the same manner as disasters, terrorism, and other large-scale events, will trigger a huge response from the military services, government organizations, and community groups. Deploying a systematic, coordinated, and timely response is the challenge of all crisis response management teams. Victims and rescuers will have different issues and need different types of support at different times before, during, and after such a threat. Spiritual reactions of survivors as a result of WMD will impact diagnosis and treatment of psychological casualties. The chaplain, as the team pastoral care provider, contributes to the design and implementation of an effective, multi-disciplinary, and cohesive intervention strategy to meet today's realization of WMD threat.