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Recently, the call for chaplains to become ‘research literate’ has been recognized by various scholars as well as by practitioners in the field. However, papers that present and discuss the study design and provide guidance on the methodology of chaplaincy research are scarce. The aim of this study is to present the design of a mixed-methods study that investigates the impact of a spiritual care intervention on patients’ spiritual wellbeing in palliative, home-based care. It reports on the steps needed to conduct such a study in chaplaincy care, and describes and discusses the study’s research design, intervention, participants, sampling strategy, patient and public involvement, procedure, ethical considerations, data collection, and analysis. Presenting and discussing such a design is not only useful for researchers before conducting their study, in order to create transparency, but also for chaplains to improve their knowledge on research methodology and research literacy.

Aim: To explore how mental health professionals address spiritual care for outpatients in weekly multidisciplinary care meetings (MDM), and to explore the barriers and facilitators in the ways health professionals address spiritual care in those meetings. Method: Two teams of mental health professionals providing care for psychiatric outpatients are included. Qualitative data were collected from audio recordings of multidisciplinary meetings and from focus-group interviews afterwards. Data were analysed using ‘open coding’. Results: Spiritual care was not frequently addressed mostly due to the requirements of the health insurance reimbursement system. Aspects of spirituality addressed in these meetings pertained mainly to meaningful daily activities. Addressing spiritual care was facilitated, on the other hand, by a holistic focus on health and recovery-oriented care. Conclusion: In ambulatory mental healthcare spirituality is sparsely addressed and, when addressed, few aspects of spirituality come into view. Facilitating healthcare professionals’ awareness of their clinical perspective is an essential step to improve spiritual care for psychiatric outpatients.

PURPOSE: The benefit of spiritual care for patients is well described, but little is known about the role of spiritual care in transgender and nonbinary patients recovering from gender affirming surgeries (GASs). METHODS: A single-center retrospective chart review was performed on patients who underwent GAS in 2017. Demographic information, surgery type, and chaplains' narrative notes were examined. RESULTS: A total of 145 chaplain visits were identified in 103 inpatient stays among 98 patients at the Mount Sinai Center for Transgender Medicine and Surgery in New York. Analysis was performed on narrative notes authored by a single chaplain, which included 132 visits among 78 transfeminine and 11 transmasculine patients. Fifty-four patients (61%) expressed gratitude for the chaplain visit and/or hospital experience overall. Seven patients (8%) described movement between religious denominations over the course of their lives, and 7 (8%) described supportive belief systems. Fifty-seven patients (64%) had a family member or friend present during the perioperative process, 13 (15%) described support systems, and 9 (10%) described supportive practices, activities, and/or coping methods. Twenty-one patients (24%) expressed concerns about current symptoms or the recovery process, and 32 (36%) received a prayer or blessing from the chaplain. Fifty-two patients (58%) consented to a follow-up call. CONCLUSION: Almost 50% of patients expressed gratitude for the chaplain's visit and more than half consented to a follow-up call from the chaplain, suggesting a chaplain can provide a welcome layer of support to postoperative GAS patients. The authors recommend integrating spiritual care into perioperative care.

There is an international movement towards integrated care. This systema- tized literature review studied healthcare chaplaincy spiritual care interventions that support adult mental health by integrating health and social care. Seventeen relevant studies were found. One analysed individual and family care in a general hospital. Twelve described one-to-one community-based interventions, of which ten concerned general practice healthcare centres. Four involved groups supporting mental health in hospitals or community-centres. Two studies used qualitative approaches, seven quantitative and eight mixed methods. The quality of evidence for the outcomes of interventions was examined. The review found that studies demonstrated shifts in healthcare professionals’ working practices anticipated by Paterson (2014), from hospital towards community bases, from treatment of individuals towards empowering ser- vice users to self-manage their health, and in mental health contexts from treatment of individuals towards care in groups.

Faith community nurses receive additional education in holistic health and intentional spiritual care, including self-caring. This study used an online survey to explore self-caring practices of faith community nurses and clinical nurses. Despite sample limitations, faith community nurses reported significantly higher levels of self-caring practices than clinical nurses.

Spiritual care is a critical aspect of end-of-life care that is often undervalued and underaddressed by hospice health care teams. The purpose of this quality improvement project was to determine if the implementation of an evidence-based spiritual care protocol changed practices regarding the initial assessment of spiritual needs, frequency of reassessment of needs, the inclusion of spiritual interventions, and staff perspectives on spiritual care. The preimplementation and postimplementation data evaluation displayed increased compliance with spiritual needs assessment within 5 days of admission, increased reassessment intervals, an increase in the percentage of interactions that included spiritual interventions, and improved staff perspectives on spiritual care. The findings of the study support implementation of a spiritual care protocol in hospice patients.

Spiritual care remains a neglected dimension in the context of living in residential aged care facilities. Using a grounded theory methodology, in-depth interviews were conducted with 17 Nepalese a...

Aim\ud To illuminate family members experiences with the spiritual care provided to their family members living with dementia in nursing homes.\ud \ud Design\ud A qualitative research design utilizing phenomenological hermeneutical approach.\ud \ud Methods\ud Data were gathered by conducting twelve in-depth interviews with family members of older people living with dementia in nursing homes and analysed using the phenomenological hermeneutical analysis. The COREQ guidance was used for reporting of this study.\ud \ud Results\ud Finding revealed that family members were worried and fearful when nursing care was routinely provided with little consideration given to spiritual needs and lacking compassion. Findings affirm that “riendliness” is an essential aspect of respectful caring from the family members' perspective. Family members want compassionate, loving, caring and dignified nursing care for their relative living with dementia in the nursing homes.

Demographic changes in Australia have led to an increase in both religious diversity and the number of people who do not nominate a faith affiliation at hospital admission. Models of chaplaincy have shifted from clerical and largely male to an increasingly skilled and diverse spiritual care workforce appointed directly by health services. This study uses survey and in-depth interview methods at an inner-city Australian hospital to examine patient preferences for hospital chaplaincy provided by faith communities, and the importance of faith affiliation compared to other spiritual care provider characteristics. Survey results indicate that of 110 respondents, a high proportion (74%) prefer spiritual care to be provided by a person of the same faith. However, when considered relative to other characteristics, faith affiliation was not as important as kindness, listening skills and a non-judgmental attitude. Our findings have implications for workforce planning and educating. Further research in different settings and with different populations will make the findings more generalizable.

Although religiosity is a strong feature of Brazilian people, the integration of spirituality in palliative care (PC) has been a challenge for health care professionals. In order to evaluate the spiritual resources used by family members of patients in PC, this work presents the results of the research carried out with 50 family members. The Satisfaction with Life Scale, Centrality of Religiosity Scale, Spiritual/Religious Coping Scale, Religious and Spiritual Struggles Scale, and Attachment to God Inventory were applied. The prevalence of positive spiritual/religious coping was very high (76%) or high (6%). There was a strong correlation between positive spiritual/religious coping and centrality of religiosity (r = 0.805; SD = 0.87). There was a moderate negative correlation between the avoidant attachment to God and centrality of religiosity (r = -0.611; SD = 1.24) and positive spiritual/religious coping (r = -0.575; SD = 1.37). There was a moderate positive correlation between the anxious attachment to God and spiritual struggles (r = 0.515; SD = 0.76) and negative spiritual/religious coping (r = 0.555; SD = 0.616). These results suggest that spiritual/religious resources are present in family members of patients in PC. These resources have been mostly ignored by the multidisciplinary team. Findings provide an evidence base for training health care professionals to better integrate spirituality in PC settings.

The purpose of this article is to research han (an oppressed feeling in Korea) through spiritual approaches including self psychology. Han is an oppressive feeling in Korean society. This han, caused by splitting, can be a place for the beginning of healing. One can invest one’s instinctual energy in the right place in the feeble self, according to one’s deepest needs there, in that spot of fragility. Many Koreans have been suffering from a deceptive self-image and do not feel deserving of love or care because of the vicious han-ridden circle. If Koreans can attain healthy self-object experiences, they will no longer feel fragility in themselves

A mudança de papéis, as perdas e as transformações físicas que caracterizam o contexto da velhice levantam a pergunta sobre o papel da espiritualidade neste cenário. O estudo objetiva analisar o modo como residentes de Instituições de Longa Permanência para Pessoas Idosas (ILPIs) utilizam a espiritualidade como recurso para o enfrentamento (coping) do estresse e do sofrimento. A pesquisa foi realizada em 18 ILPIs da região Norte do Paraná, com 188 participantes. Trata-se de um estudo descritivo, com abordagem quantitativa com estudo de campo de corte transversal. Os dados foram coletados a partir da aplicação da Escala de Coping Espiritual Religioso (CER BREVE), da Escala da Centralidade da Religiosidade e questionário sociodemográfico. Os resultados apontam média da amostra do CER Positivo (M=4,14 e DP=0,78) e o CER Negativo (M=1,23 e DV=0,49). A amostra analisada (4,0 a 5,0) indica que a religiosidade é central na vida da pessoa idosa institucionalizada, considerada altamente religiosa. Conclui-se que as pessoas idosas reconhecem a importância da espiritualidade/religiosidade e se beneficiam dela para enfrentar os problemas e superá-los. Fornecer treinamento para o cuidado espiritual de pessoas idosas pode ser uma grande contribuição da Teologia a fim de promover melhores cuidados em ILPIs.

The text deals with the experience of Czech hospital chaplains in 2020. Specifically, it concerns the period during the spring and autumn waves of the pandemic caused by the spread of the SARS-CoV-2 virus which leads to a viral disease known as covid-19. The article builds on data obtained through an online questionnaire and subsequent ten interviews with hospital chaplains. The results of the research are presented in four thematic blocks: chaplain and institutions, chaplain and staff, chaplain and patient, and the chaplain himself. Based on a qualitative analysis of the data, we conclude that the pandemic affected the self-concept of many chaplains. It mainly depended on their effectiveness, that is, the possibility of applying their skills, in the hospital during the pandemic. In many cases, the pandemic crisis has accelerated the development of relations with the institution and staff, for better or worse. The position of the chaplain in the hospital before the outbreak of the pandemic proved to be crucial. The work with patients themselves did not usually undergo a fundamental change; the chaplains often functioned here as a substitute for forbidden visits. At the end of the article, we present some practical recommendations resulting from our data.

Background: The provision of spiritual care is a key component of high-quality patient-centered care, particularly in the intensive care unit (ICU). However, the integration of spiritual care into the care of patients in the ICU is variable, especially at the end of life, which may be due in part to poor or incomplete provider knowledge of the work of chaplains. Objective: To characterize the care and services provided by chaplains to patients in an ICU at the end of life and/or their families. Design: A retrospective chart review was performed to identify all patients admitted over a three-month period to an ICU who had visits with a chaplain and an ICU course that ended in death, discharge to a palliative care facility or discharge to hospice. Subjects/setting: Twenty-five chaplains at a U.S. medical center. Measurements: Qualitative analysis was performed using directed content analysis on the notes written by the chaplains. Results: Qualitative analyses of the chaplain notes revealed four broad themes regarding the activities of chaplains in the ICU with respect to patients and families. These were that chaplains provide comfort to patients and family facing the end of life, provide prayers with a variety of purposes, assist in supporting family members through complex medical decision making, and provide connections to appropriate resources. Conclusions: Chaplains contribute to the care of patients in the ICU through a wide range of activities that demonstrate the unique intermediary and collaborative role chaplains can play within the health care team at the end of life in the ICU.

Military personnel deployed to war zones or assigned to other morally challenging military duties are likely to be exposed to potentially morally injurious events (PMIE) that may inflict a moral injury (MI). This qualitative study formed ‘Phase 1’ of a larger study into PMIEs experienced by Australian veterans and the potential pastoral/spiritual care role of chaplains. Two seminars were conducted that involved 10 veterans being interviewed and audio recorded about their deployment experiences to evaluate whether there was any evidence among Australian veterans of a PMIE. Narrative data analysis indicated that all participants had been exposed to, or were involved in, a PMIE of one kind or another. Seven key themes were identified from the analyzed qualitative data: (i) immoral acts, (ii) death and injury, (iii) betrayal, (iv) ethical dilemmas, (v) disproportionate violence, (vi) retribution and (vii) religious/spiritual issues. Given this preliminary PMIE evidence identified, there is a need for further research, as well as the development of a suitable moral injury assessment scale appropriate for Australian veterans. Furthermore, given the ethical, moral, and spiritual issues involved, the implementation of a rehabilitation program suitable for Australian veterans which can be provided by chaplains is also suggested—namely ‘Pastoral Narrative Disclosure.’ It is argued that moral injury needs to be recognized, not just as an issue affecting individual personnel and their families, but is also a community health, organizational and government responsibility.

Combat trauma experienced in a warzone can hamper the physical, mental, and spiritual health of military service members and Veterans for years afterward. Spiritual care for combat trauma is designed to help service members and Veterans find meaning and purpose in their experiences. One such spiritual care program is REBOOT Combat Recovery, a 12-week, Christian-based course led by trained volunteers across the country. An in-depth investigation of the REBOOT program is needed to advance knowledge of spiritual care for combat trauma and to assess the course in attendees��� own words. Semi-structured interviews were conducted with 40 course graduates. Experiences of the course were positive. Interviewees identified the program���s emphasis on peer fellowship, spirituality, and the roots of distress as reasons for its effectiveness (RQ1). The most helpful aspects of the program involved the hospitality and family focus; targets for improvement included maintaining fidelity to the curriculum and offering opportunities for continuity upon graduation (RQ2). Interviewees described a variety of ways the course affected their view of self, their relationship with God and others, and their perceptions of combat trauma (RQ3). These findings are valuable for enriching spiritual care, in general, and enhancing the REBOOT Combat Recovery program, in particular.

One of the essential non-pharmacological treatments for patients with chronic diseases are psychosocial supports and counselling services such as spiritual psychotherapy. Although several preliminary studies represent the effects of counselling and spiritual psychotherapy on anxiety in patients with chronic diseases, there are various contradictions among the findings. The present meta-analysis aimed to determine the effects of counselling and spiritual care programs on anxiety in patients with chronic diseases. For data collection, various databases were searched regarding no time limitation until May 2021, including SID, MagIran, Embase, ProQuest, Scopus, PubMed, and Web of Science (WoS) using Google Scholar search engine. Inclusion criteria were original research articles, interventional studies, and exclusion criteria were irrelevant assessments, systematic review and meta-analysis studies, case reports, letters to the editor, and duplicate papers. I2 test was used to calculate heterogeneity of studies, and the Egger’s test was applied to examine the publication bias. According to the inclusion criteria, 26 articles were selected among 612 initial papers with a sample size of 1040 individuals. The mean anxiety scores before and after the interventions were 33.02 ± 3.77 and 25.27 ± 3.66, respectively. The significant (P

Background and Objectives Spiritual care aims to counter negative outcomes from spiritual distress and is beneficial to persons living with dementia. Such care needs dementia-appropriate customization. We explored the salient spiritual needs in dementia to inform future intervention development. Health care providers are well situated to observe the nature of spiritual needs across and within medical conditions. Research Design and Methods We conducted semistructured qualitative interviews with providers. We sampled purposively by discipline (chaplains, nursing staff, social workers, activities professionals) and religious tradition (for chaplains). Our interview guide inquired about, for example, the nature of spiritual needs in dementia and stakeholders’ roles in addressing them. Inductive/deductive thematic analysis was employed. Results 24 providers participated. The thematic structure consisted of 2 themes: (a) spiritual experience in dementia differs from that in other medical conditions (subthemes: fear, profound loss of self, progressive and incurable nature, and impacted ability to access faith) and (b) the need for spiritual intervention at the mild stage of dementia (subthemes: awareness in mild dementia and its influence on spiritual distress, and a window of opportunity). Discussion and Implications We learned about the potential “what” of spiritual needs and “who” and “when” of implementing spiritual care. Implications included the imperative for dementia-specific spiritual assessment tools, interventions targeting fear and loss of self early in symptom progression, and stakeholder training. Researchers should study additionally the “how” of dementia-appropriate spiritual care. Conjointly, these efforts could promote spiritual well-being in persons living with dementia worldwide.

During psychotherapy assessments clinicians may recognize that some of their injured and traumatized clients may be wrestling with issues related to a lack of forgiveness linked to Moral Injury (MI). This paper presents the Forgiveness Interview Protocol (FIP), a narrative therapy writing-process model for the treatment of Moral Injury, drawing upon the philosophical work of Margaret Holmgren: “Forgiveness and the Intrinsic Value of Persons” (1993) now linked to a variety of evidence-based psychological sources. The FIP utilizes three distinct theoretical and clinical disciplines to arrive at a semi-structured interview intended for mental health counseling, and religious and spiritual care.

Purpose Integrating spirituality into the patient care within a healthcare team, increases the ability to provide “holistic care” for cancer patients. The spiritual care experiences of different involved persons can be a guide for future planning. Therefore, this study aimed to explore the spiritual care experiences of hospitalized cancer patients, their family caregivers and healthcare team members in oncology settings. Methods This is a descriptive qualitative study which was conducted with 21 participants, who were selected by purposive sampling. Semi-structured interviews were used to collect the data. The data were analyzed with conventional content analysis method. Results Two themes of "systematic care" and "caring with paradoxical results" were extracted from the spiritual care experiences of our participants. Conclusions Spiritual care as professional, comprehensive, collaborative and artistic care should be provided in a multidisciplinary healthcare team for cancer patients. Otherwise, patients may experience deprivation of spiritual services and consequently, spiritual distress.

Purpose To identify the spiritual needs of children and adolescents with chronic illnesses and how these needs are met by health professionals during hospitalization. Design and methods A qualitative descriptive study was developed with 35 children and adolescents, between 7 and 18 years old, diagnosed with cancer, cystic fibrosis, and type 1 diabetes. Interviews with photo-elicitation were conducted during the hospitalization at a Brazilian public pediatric hospital. Findings were treated using thematic analysis, and the Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed for quality reporting. This research was approved by a research committee. Results Two themes emerged. The first, entitled ‘Spiritual needs’, encompasses five types of needs: (1) need to integrate meaning and purpose in life; (2) need to sustain hope; (3) need for expression of faith and to follow religious practices; (4) need for comfort at the end of life; and (5) need to connect with family and friends. The second theme was the ‘Definition of spiritual care’. Conclusions Children and adolescents with chronic illnesses have spiritual needs while in hospital. Meeting these needs is essential for finding meaning, purpose and hope in the experience of living with chronic illnesses and at the end of life, based on their faith, beliefs and interpersonal relationships. But, these needs have not been fully addressed during hospitalization. Practice implications These results emphasize the need to implement spiritual care when caring for hospitalized pediatric patients, which includes addressing spiritual needs.

To provide spiritual care, an assessment and documentation of patients´ spiritual struggles and/or their spiritual needs is required to initiate appropriate support planning processes. For that purpose, the Spiritual Needs Questionnaire (SpNQ) was developed in 2009 as an easy to apply standardized measure. The tool has so far been translated into numerous languages and is widely used as a valid and reliable instrument to assess a wide range of spiritual needs of patients with chronic diseases, elderly, adolescents, and healthy persons. Its four main factors address Religious needs, Existential needs, Inner Peace needs, and Giving/Generativity needs. Here, the main findings are summarized and discussed.

Latar belakang : Kebutuhan dasar pasien meliputi kebutuhan fisik, psikologis, sosial dan spiritual. Kebutuhan spiritual diberikan kepada pasien di ruang ICU melalui layanan perawatan spiritual. Perawatan spiritual merupakan suatu praktik dan prosedur yang dilakukan oleh perawat pada pasien untuk memenuhi kebutuhan spiritual pasien melalui doa, shalat, dzikir etc. Tujuan: Penelitian ini bertujuan untuk menggali persepsi perawat tentang kebutuhan spiritual pasien. Metode: Metode yang digunakan dalam penelitian ini adalah dengan menggunakan eksplorasi deskriptif kualitatif. Hasil: Analisa data kualitatif menggunakan NVivo Plus Dua Belas menghasilkan tema kebutuhan spiritual pasien yang terdiri dari dua kategori yaitu pemberian dan pemenuhan. Kesimpulan: Kebutuhan spiritual merupakan kebutuhan dasar yang dibutuhkan oleh pasien di ruang ICU.

Purpose: The study was conducted to examine the spirituality and spiritual care perceptions of nursing department students. Methods: The study was conducted in descriptive design with nursing students at a state university. Permission was obtained from the ethics committee, the institution, and the students before the study. The universe of the study consisted of all nursing students studying at the faculty, and the sample consisted of a total of 500 students who were willing to participate in the study. The data were collected with a questionnaire and with the Spirituality and Spiritual Care Detection Scale. The scores received from this scale were between 17 and 85, and high total scores suggest that the spirituality and spiritual care detection scale level is “good.” The data obtained in the study were evaluated with the Student t, one-way ANOVA, and Mann-Whitney U test. Results: It was determined that 66.2% of the students had knowledge about spiritual care, 27.4% received this knowledge from the school, and 60.2% met the need for spiritual care with worshiping. It was determined that the mean spirituality and spiritual care detection scale score of nursing students was 66.83 ± 5.01, and the mean spirituality and spiritual care detection scale score was statistically significant according to the grades (p < 0.05). It was also found that the students with an authoritarian family structure had lower mean spirituality and spiritual care detection scale scores than students with democratic and protective families. Conclusions and Recommendations: It was found that many nursing department students had knowledge on spirituality and spiritual care, the mean spirituality and spiritual care score was “good,” and that the family structure and the grade affected this situation. In this respect, it is recommended that students are supported and prepared for the clinic with topics including spirituality and spiritual care in nursing education.

The Interprofessional Spiritual Care Curriculum (ISPEC) was created to train interdisciplinary health care teams to recognize and address the spiritual needs of seriously or chronically ill patients. The curriculum, in a train-the-trainer format, employs didactic presentations, discussions, lab sessions, skill demonstrations, and video clips. In course applications, participants were required to submit goals to achieve and demonstrate institutional support. For the first ISPEC course, in July 2018, 48 clinician-chaplain teams attended. Following the 2½ day course, participants had access to online training modules for 1-year, ISPEC faculty mentoring support, and regular conference calls on goal implementation progress. Participants reported recognizing the importance of providing spiritual care and a new understanding of how collaborating as interprofessional teams enabled them to integrate this care into their home institution settings. In a mixed-methods evaluation survey completed 12 months after the ISPEC course, participants reported on the percentage of their goals completed, number and types of professionals they had educated in spiritual care, and personal confidence regarding spiritual care leadership skills. This data can serve as a model to guide other organizations striving to improve spiritual care, practiced collaboratively by clinicians and chaplains, as an essential aspect of overall QI efforts in palliative care.

This is a cross-sectional, descriptive and correlational study aiming to reveal the relationship of gratitude and coping styles with depression in caregivers of children with special needs. As a result of the study, which was conducted with 330 caregivers, it was determined that the caregivers' level of gratitude was high. In this study, it was found that the caregivers used mostly turning to religion, planning, positive reinterpretation, and instrumental social support as coping styles respectively. It was established that there was a significant correlation between caregivers' depression level and gender, education level, level of gratitude, focus on and venting of emotions, substance use, behavioural disengagement, positive reinterpretation, using emotional social support and planning coping styles. The depression disclosure level was found to be 17.8%. For holistic nursing care, the assessment of spiritual care and spiritual needs of caregivers is very important because of its positive effect on mental health.

In religiously pluralized societies, caregivers frequently care for patients or clients with a religious, spiritual, or secular orientation that differs from their own. Empirical studies exploring the implications of this faith diversity for spiritual care interactions between caregivers and clients are scarce. Some literature suggests that similarities in faith orientation between caregivers and clients relate to better professional caring relationships than encounters with dissimilar faith orientations, while other studies suggest that faith similarities do not relate, or relate only under certain conditions, to the way in which professional caring relationships are perceived. This study supports the second line of thought. Based on a survey among 209 clients and 45 chaplains in hospitals in the Netherlands, it shows that clients in faith-concordant encounters evaluate the spiritual care encounter just as positively as do clients in faith-discordant encounters. This is in line with broader trends of secularization and blurring of boundaries between the religious, spiritual, and secular domains.