Role Of Chaplain Research Articles

Being There, Virtually Being There, Being Absent : Chaplaincy in Social Care During the COVID-19 Pandemic

The term “being” has featured frequently in publications about the role of chaplains in health and social care. Generally, this has described the physical presence of chaplains among people either during routine pastoral encounters or at critical moments in their lives. The COVID-19 pandemic has led to differentiated practices for chaplains in the UK’s largest charitable care provider for older people. Some chaplains continued to be present in residential care facilities; some provided at-distance support; and some were absent, both physically and virtually. This article begins by discussing the significance of “being” in the context of chaplaincy. It goes on to offer examples of analysis, drawing on chaplaincy experience during the pandemic based on six interviews conducted in the final week of May 2020. From these interviews, an evaluation is made of chaplaincy during the crisis as: being present; virtually being present; and being absent. It is noted that questions about the chaplain’s location in a crisis are not unprecedented. A discussion of pastoral care during the pandemic suggests that presence and in-person encounter remain key aspects of being, and that recent experience has clarified the importance of embodied support for those who are suffering. However, it is also noted that under certain conditions a virtual pastoral encounter has value, can convey impact, and is of consequence.

The role of religion and spirituality in caregiver decision-making about tracheostomy for children with medical complexity

Children with medical complexity (CMC) receive life-sustaining treatments such as tracheostomy. The objective of this paper is to explore the roles of religion and spirituality (R&S) of caregivers of children with medical complexity (CMC) in their decision to pursue tracheostomy for their children. We conducted 41 in-depth interviews of caregivers of CMC who had received tracheostomies in the prior 5 years. Four themes emerged: (1) Caregivers believed R&S to be powerful for their children’s healing, and helped them cope with their children’s illnesses; (2) Spirituality was an important factor for caregivers in the decision to pursue tracheostomy for their children; (3) Many caregivers did not discuss their spirituality with clinicians for a variety of reasons; (4) Clergy and hospital chaplains played a major supportive role overall; however, they did not play a significant role in the decision-making process. Our study shows the importance of R&S, and the roles of clergy and chaplains in pediatric tracheostomy decision-making.

Staff perceptions on the role and value of chaplains in first responder and military settings: A scoping review

Background
 Chaplains in first responder and military services support staff prior to, during and after critical incidents. Some studies have explored the role of chaplains in these settings predominantly in the military and from chaplains’ perspectives. However, few studies have explored the perspective of staff. This scoping review aims to map the literature on staff perceptions of the role and value of chaplains in first responder and military settings.
 
 Method
 A scoping review using the Arksey & O’Malley (2003) and Joanna Briggs Institute Scoping Review Methodology was conducted. English language peer-reviewed and grey literature in CINAHL, PubMed, PsychINFO, ProQuest and Google Scholar from 2004-2019 was reviewed for inclusion. Records were included if they provided staff perspectives on the role and value of chaplains in first responder and military settings. The initial search identified 491 records after removal of duplicates. All titles and abstracts were then screened for relevance to the research question and 84 were selected for full-text review. Seven records were included in final review; five dissertations and two peer-reviewed articles. Five of these were from the military and two from the police. Data were extracted and thematically analysed to identify staff perceptions of the role, skills and attributes, and value of chaplains in first responder and military settings.
 
 Results 
 Staff understood the role of chaplain to include the provision of spiritual and pastoral care and guidance and, in the case of police, providing scene support. Staff from all of the services identified requisite skills and attributes for chaplains such as being available, approachable and engaged; counselling; maintaining confidentiality and trust; being organisationally aware; and possessing distinct personality traits and knowledge of specialty content areas. The value chaplains brought to their services emerged from chaplains being trusted as a result of being proactively available for staff, families and bystanders for formal and informal conversation; organisational belonging and awareness resulting in enhanced staff satisfaction and retention; and promoting staff physical, mental, social and spiritual wellbeing.
 
 Conclusions
 Although military and police staff identified spiritual, psychological and social benefits to chaplains maintaining an active and visible role in their services, the small number of papers identified make generalisation of these findings to other first responder services problematic. Further research is therefore required to understand the impact of the chaplain’s role as part of the care team in first responder services.

Understanding the role of chaplains in supporting patients and healthcare staff.

To investigate attitudes towards chaplaincy in NHS Scotland, including the role of the chaplain in supporting healthcare staff. This was a qualitative study that involved semi-structured interviews with four chaplains working throughout NHS Scotland. The research transcripts were analysed, and themes were identified and examined. Two main themes were identified from the interviews: understanding the role of the chaplain; and understanding the future role of the chaplain. The sub-themes identified were: healthcare staff members' perceptions; chaplains' perceptions; generic chaplaincy services; and becoming an allied healthcare profession. The findings of this study suggest that chaplains are increasingly providing support to healthcare staff, alongside their role in providing support to patients. The researchers also identified that chaplains in Scotland are adopting an increasingly educational role and that, in the future, they may adopt reflective practice programmes to assist them in managing increased requests for chaplaincy support from healthcare staff. It was also acknowledged that chaplaincy services may also be required to become an allied healthcare profession in the future, which may require chaplains to provide an increasingly generic and less religious service.

Spirituality, Religion, and Medicine Education for Internal Medicine Residents

Spirituality and religion affect patient health. This topic is often not included in medical resident education. We aimed to evaluate resident knowledge, attitudes, and skill regarding spirituality, religion, and medicine and to develop, implement, and evaluate a curriculum to improve these measures. Internal medicine residents at a large, urban academic center were surveyed to determine their baseline knowledge, attitudes, and skill regarding spirituality and religion (37.4% response rate, n = 46/123). A lecture and discussion-based curriculum was implemented over 1 year, followed by another survey (41.4% response rate, n = 51/123); χ2 statistic was used to compare pre- and postsurveys to evaluate the curriculum. Baseline resident attitudes toward spirituality, religion, and medicine were high with most agreeing chaplains are valuable in patient care (93.5%) and that patient spiritual and religious beliefs can affect health (93.5%). Resident self-reported knowledge and skill were low with few knowing the training chaplains receive (4.3%) or reporting competence taking a spiritual history (15.2%). After the curriculum, resident self-reported knowledge increased regarding the role of chaplains (56.5%-80.4%, P = .011) and the training chaplains receive (4.3%-27.5%, P = .002). No significant postcurriculum change was seen in attitudes or skill. Most internal medicine residents have positive attitudes toward spirituality, religion, and medicine. They do not have adequate knowledge or skill to care for patients in this area, however. Implementation of a curriculum in spirituality, religion, and medicine improved resident self-reported knowledge. Future work should focus on revising the curriculum to better improve resident knowledge and skill.

Quality of Spiritual Care at the End of Life: What the Family Expects for Their Loved One

Spiritual care at the End of Life (EOL) is a “keystone” investment at any Regional Tertiary Acute Care Hospital. Spiritual Care Departments need to demonstrate quality indicators in the provision of spiritual care at an EOL not only for their patients, but to satisfy family expectations of that care for their loved one. A fixed choice survey instrument using a structured interview via telephone was utilized for 202 criterion families who had lost a loved one. Three domains surfaced: (1) Families retained traditional chaplain role expectations of Priestly/Liturgical (78.6%) and Pastoral/Shepherd (67.5%); (2) Expectations of an expanded chaplain role after the EOL (50%); and, (3) Traditional spiritual care services regardless of one’s religion or spirituality: Comfort and care, emotional support (96%); active listening (96.5%); the Chaplain as a reminder of God’s presence (93.6%); prayer (96%); scripture reading (69.3%); and ritual/sacramental anointing of the sick (71.3%).

Intensive Care Clinicians’ Views on the Role of Chaplains

There is evidence that addressing the religious and spiritual needs of patients has positive effects on patient satisfaction and health care utilization. However, in the intensive care unit (ICU), chaplains are often consulted only at the very end of life, thereby leaving patients’ spiritual needs unmet. This study looked at the views of 219 ICU clinicians on the role of chaplains. We found that all clinicians find chaplains helpful when a patient is dying or when the chaplain brings up religious or spiritual topics. Physicians find chaplains less helpful in other clinical scenarios such as challenging family meetings or when patients are recovering. Nurses are more likely to consult chaplains for a difficult family meeting or when patients are recovering from critical illness. Communication between clinicians and chaplains, both directly and indirectly through electronic health record notes, remains infrequent, highlighting the need for interventions aimed at improving multidisciplinary spiritual care.

Catholic Chaplains in Public Institutions: Contextual Opportunities and Institutional Inertia in Spanish Hospitals and Prisons

This article analyses the roles of Catholic chaplains amidst secularisation and diversification in Spain. Instead of focussing on highly politicised and controversial issues, we examine lower-profile negotiations taking place in secular public institutions. With this micro-sociological approach, we move the analysis beyond the official stand of the national Catholic hierarchy and examine everyday interactions and negotiations between front-line Catholic actors, civil servants, and religious minorities’ leaders who share—and compete for—time, space, and material and symbolic resources in public hospitals and prisons. We argue that rather than resisting the changes strenuously, Catholic chaplains strategically re-define and diversify their roles by taking advantage of contextual opportunities, institutional factors, and organisational inertia. This attitude, which diverges from the more confrontational stance of the hierarchy in the public sphere, allows them to adapt to the environment and maintain their position and relevance within these institutions.

The Role of Healthcare Chaplains in Resuscitation: A Rapid Literature Review.

Spirituality is becoming of increasing importance in the international healthcare context. While patients' spirituality or faith is often overlooked, there is a growing awareness that understanding, addressing and supporting patients' spiritual and faith needs can influence healthcare outcomes. This review aims to illuminate this role and highlight healthcare chaplains' potential in relation to the provision of pastoral support for families during and after patient resuscitation, and the dearth of interdisciplinary education in this field. A rapid structured review was undertaken using four databases-PubMed, CINAHL, PsycINFO and ATLA. Primary research studies published during the 10-year period 2007-2017 written in English addressing the chaplain's role or perceived role in resuscitation were included. An initial search using key terms yielded 18 relevant citations. This reduced to 11 once duplicates were removed. Ultimately five relevant primary research studies were included in the final analysis. This review found few studies that directly explored the topic. Certainly many view the chaplain as a key member of the resuscitation team, although this role has not been fully explored. Chaplains likely have a key role in supporting families during decisions about 'not for resuscitation' and in supporting families during and after resuscitation procedures. Chaplains are key personnel, already employed in many healthcare organisations, who are in a pivotal position to contribute to future developments of spiritual and pastoral care provision and support. Their role at the end of life, despite well described and supported, has received little empirical support. There is an emerging role for chaplains in healthcare ethics, supporting end-of-life decisions and supporting family witnessed resuscitation where relevant. Their role needs to be more clearly understood by medical staff, and chaplain's input into undergraduate medical education programmes is becoming vital.

Collaborating With Hospital Chaplains to Meet the Spiritual Needs of Critical Care Patients.

There are many opportunities for critical-care nurses to collaborate with chaplains in an effort to provide spiritual care for patients and their families. By recognizing the educational requirements as well as the unique roles of board-certified chaplains (BCCs), the critical-care nurse will view them as respected members of the health care team. This collaboration positively impacts the work environment and creates a holistic space for healing for patients, as well as the health care team. As nurses, we must educate and inform novice nurses about the important role of BCCs on the interdisciplinary health care team. Critical-care nurses need to incorporate the BCCs' contributions into the patient plan of care during bedside report in a way that helps the nurse understand the connection between the patient's spiritual health and his/her experience as a patient.

"He Must Die or Go Mad in This Place": Prisoners, Insanity, and the Pentonville Model Prison Experiment, 1842-52.

summaryThe relationship between prisons and mental illness has preoccupied prison administrators, physicians, and reformers from the establishment of the modern prison service in the nineteenth century to the current day. Here we take the case of Pentonville Model Prison, established in 1842 with the aim of reforming convicts through religious exhortation, rigorous discipline and training, and the imposition of separate confinement in its most extreme form. Our article demonstrates how following the introduction of separate confinement, the prison chaplains rather than the medical officers took a lead role in managing the minds of convicts. However, instead of reforming and improving prisoners’ minds, Pentonville became associated with high rates of mental disorder, challenging the institution’s regime and reputation. We explore the role of chaplains, doctors, and other prison officers in debating, disputing, and managing cases of mental breakdown and the dismantling of separate confinement in the face of mounting criticism.

Ksiądz Pułkownik Józef Panaś (1887–1940) Kapelan Legionów Polskich, działacz polityczny i publicysta

The purpose of this dissertation is to present the significant achievements and activities of this chaplain in many areas of his life. He is not a person well known and has not gained a rightful place in the Polish historiography. The author of this dissertation attempted to analyze the role of chaplain in the functioning of the Polish Legions, the battle for Przemyśl and pastoral work in the Polish Army. Also considered the impact of the priest chaplain on the activities of the peasant movement, attempted to determine the degree of the impact of journalism Socio-political face of ideological and programmatic opposition government. The author did not omit the question of the position of chaplain in the structures of conspiracy Lvov under Soviet occupation.

Handling Challenges Inherent in the Hospice Chaplain Role

With an increasing number of terminal patients in the United States dying in the context of hospice, the role that hospice chaplains play in providing spiritual care for patients and their families is important to examine. The hospice chaplain role requires careful navigation of the development of relationships that may end abruptly, the expectations of hospice organizations, and the needs of both patients and families. The current study uses the concept of competing role dialectics to further our understanding of the challenges chaplains face as they enact this crucial role. Data from 45 current and former hospice chaplains reveal four major role tensions hospice chaplains must develop strategies to handle: fostering relationships versus fostering autonomy, acting as team members versus acting as individuals, serving the family unit as a whole versus serving particular family members, and following the agendas of patients and families versus following one’s own agenda.

Space, Time and Shared Humanity: A Case Study Demonstrating a Chaplain’s Role in End-of-Life Care

Care is often perceived as “doing something”; spiritual care also involves “being with” another person. This case, set in a hospice inpatient unit, highlights a relationship between being and doing, and the role of chaplains within multi-disciplinary teams, in palliative care. During ward round, a patient learned that he was dying. He appeared overwhelmed; he had a young family and much to organize. Following an informal assessment, the chaplain’s aim was to offer him time and the opportunity to talk. For both, this became a space of uncertainty and vulnerability. It represented a pivotal point in his care as he regained control. After this encounter, other members of the multidisciplinary team assisted him to do what he needed. He died peacefully. The case demonstrates the value of spiritual care in relationship with the support of physical, psychological and social needs of people at the end of life, and their families.

A Nexus of Eyes: The Praxis of Chaplaincy in One Faith Based Educational System Through Emerging Emic Perspectives

Internationally chaplaincy as a whole, and school based chaplaincy in particular, is morphing into new forms within emerging national uncertainties, and cultural diversity. Drawing on their work in Ireland, King and Norman (2009) believe that the role of school chaplains everywhere needs to be carefully realigned and rethought. This paper seeks in part to address this situation, unpacking the initial ‘emic-journey’ of a three year multi-case study research agenda that seeks to holistically investigate how key stakeholders in three faith based schools understand the role and practice of school chaplains. In this instance, the stakeholders included administrators, chaplains and students. The multi-case study approach and the stratified sets of respondents were deemed to be the best ‘goodness of fit’ as Parekh’s (2000) axiom clearly states an understanding that one group’s place within an organisation needs to be considered not in isolation, but as intersecting forces that act as a “locus of identity.”

Integrating Spiritual Care into Palliative Consultation: A Case Study in Expanded Practice.

Recognizing and addressing spiritual needs has long been identified as a key component of palliative care (PC). More often than not, the provision of spiritual care involves referral to a hospital chaplain. In this study, we aim to describe the role of a PC chaplain embedded within the interdisciplinary PC team and demonstrate how this palliative chaplain role differs from that of a traditional hospital chaplain. We postulate that integrating spiritual care provision into a PC team may offer a broader spiritual care experience for patients receiving PC and begin to delineate expanded clinical roles for the palliative chaplain.

Moral Injury and Definitional Clarity: Betrayal, Spirituality and the Role of Chaplains.

This article explores the developing definition of moral injury within the current key literature. Building on the previous literature regarding 'Moral Injury, Spiritual Care and the role of Chaplains' (Carey et al. in JORH 55(4):1218-1245, 2016b. doi: 10.1007/s10943-016-0231-x ), this article notes the complexity that has developed due to definitional variations regarding moral injury-particularly with respect to the concepts of 'betrayal' and 'spirituality'. Given the increasing recognition of moral injury and noting the relevance and importance of utilizing a bio-psycho-social-spiritual model, this article argues that betrayal and spirituality should be core components for understanding, defining and addressing moral injury. It also supports the role of chaplains being involved in the holistic care and rehabilitation of those affected by moral injury.

Critical Care Nurses’ Perceptions of and Experiences With Chaplains

We explored critical care nurses’ experiences with chaplains and perceptions of spiritual care. This was a qualitative study, using in-depth interviews and focus groups with critical care nurses at an academic medical center. Data were audio recorded, transcribed verbatim, and analyzed using inductive coding methods. The study included 31 nurses (19 interviews and 2 focus groups). Participants did not feel completely prepared for spiritual assessments; they felt the urge to consult with spiritual providers predominantly for end-of-life situations. Respondents reflected several factors in the provision of spiritual care to patients and their families, such as patient’s and/or family’s spiritual needs, resources available at an institution, and the nurse’s own religious and/or spiritual beliefs. Nurses’ perceived role of chaplains overlapped what nurses can offer as part of holistic care, such as listening, praying, and counseling. Yet, participants acknowledged they paid more attention to the physical facets of a patient’s illness. Participants noted a need for better system-wide approaches to enhance nurses’ capacity for spiritual care, as well as earlier spiritual assessments of patient and family spiritual needs. Future research should address how integration of the spiritual care providers into the care team can improve spiritual support of patients, families, and clinicians.

A Look at Israel’s Next Generation of Spiritual and Pastoral Care Providers

This brief report looks at the demographics as well as professional background and experiences of a sample of Israeli chaplains. An online survey was distributed to 39 Israeli chaplains, yielding a response rate of n = 6 (15.4%). The findings notably highlight the role of women as chaplains, supporting a religiously diverse population, and differing perspectives on the functional role of a chaplain. These findings could help facilitate discussion and future research into chaplaincy services in Israel.

The Sport Chaplain's Role in the Holistic Care Model for Collegiate Athletes in the United States

More than 460,000 National Collegiate Athletic Association (NCAA) student–athletes compete in twenty-three sports each year. These student–athletes receive a spectrum of services that include academic support to medical care. This paper examines the role and function of sport chaplains who work in a collegiate (colleges and university) athletics in the United States. The role of the collegiate sport chaplain in the provision of holistic care in a collegiate athletics environment is examined. Additionally, a conceptual model of holistic care is presented that includes traditional and emerging parties in the chain of care. More student–athletes are aware of the importance of spirituality in their lives, and the role of the sport chaplain's ministry becomes increasingly important to the individual player and the team. Finally, a practical theology of sport chaplaincy includes the primacy of the ‘shepherding’ function in the holistic care model.