It is well accepted that attention to spiritual concerns is a core dimension of palliative care. It is similarly well accepted that chaplains are the spiritual care specialists who should address such concerns. However, what chaplains do when they provide care for patients and families is often poorly understood by their palliative care colleagues. Having a clear understanding of what chaplains do is important because it contributes to improved utilization of the spiritual care and other resources of the palliative care team and thereby to better care for patients and families. The aim of this study was to describe what palliative care physicians, nurses, and social workers understand about what chaplains do. Brief surveys were distributed to participants at 2 workshops for palliative care professionals in 2016. The survey was completed by 110 participants. The majority reported that they understood what chaplains do moderately well or very well. Thirty-three percent of the written comments about what chaplains do were very general; 25% were more specific. Only a small proportion of the participants were aware that chaplains provide care for the team, are involved in facilitating treatment decision-making, perform spiritual assessments, and bridge communication between the patient/family/team/community. Based on our survey, palliative care colleagues appear to have a broad understanding of what chaplains do but many may be unfamiliar with important contributions of chaplains to care for patients, families, and teams. These findings point to the need for ongoing education of palliative teams about what chaplains do in palliative care.
In recent years, some within chaplaincy have advocated for a stronger focus on outcomes, including outcome research, whereas others in the field have questioned an outcome-oriented perspective. In this article, existing outcome studies are reviewed in relation to the ongoing discussion about a processor outcome-oriented approach to chaplaincy. A central question emerges from this discussion: how can outcome research be designed that respects the integrity of the profession of chaplaincy? A literature search in MEDLINE/Pubmed produced twenty-two chaplaincy outcome studies that met the inclusion criteria. A review of these studies shows that thus far most have focused on secondary chaplaincy outcomes (e.g., satisfaction) using quantitative designs. To respect the integrity of chaplaincy,
In ‘a secular age’ (Taylor 2007), pastoral care is no longer exclusively associated with specific religious traditions and communities. Pastoral caregivers who work in secular institutions provide care to religious and nonreligious people alike, and in several Western societies the term pastoral care is used in relation to nonreligious (humanist) care. In secular contexts, the term ‘pastoral care’ is often replaced by the term ‘spiritual care.’ Spiritual care, however, is provided by various professionals, so pastoral caregivers face the challenge of developing adequate and convincing language to explain what is distinctive about their work. In this article, the authors turn to philosophical language in order to develop a conceptual understanding of pastoral care that does not depend on the specific worldview—religious or nonreligious—of either pastoral caregivers or receivers of pastoral care. Using the work of Taylor (1989, 2007) and Murdoch (1970), we explain pastoral care as engaging with people’s attempts to orient in ‘moral space’ and the distinctive quality of pastoral care as ‘representing the Good.’ Murdoch associates ‘the Good’ with a secular idea of transcendence that is both a movement beyond the ego and an engagement with the reality of human vulnerability, suffering, and evil. We argue that pastoral caregivers who ‘represent the Good’ have the task not only of supporting the existential and spiritual processes of individuals but also of promoting dialogue and social justice and of critiquing dehumanizing practices in the organizations in which they work and in society at large.
Objective Although the Dutch Functional Assessment of Chronic Illness Therapy—Spiritual Well‐Being 12 Item Scale (FACIT‐Sp‐12) has been used in several Dutch studies, no study has assessed the measurement properties of the translation. The aim of this study was to perform an item‐reduction analysis, confirmatory factor analysis (CFA), test of reliability, and test of convergent validity. Methods From the baseline data of a cohort study on experienced quality of care and quality of life (eQuiPe study), 400 advanced cancer patients without missing values on any of the variables were selected. In addition to demographic and religious/spiritual characteristics, study measures included the FACIT‐Sp‐12 and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire‐C30 (EORTC‐QLQ‐C30). Results Item reduction analysis showed that Items 4 and 8 had low correlations to the total scale (<0.30). Items 6 and 7, and Items 9, 10, and 11 were highly correlated (>0.75). CFA indicated a good fit for a three‐factor structure with Meaning, Peace and Faith, and good Cronbach's α coefficients for the total as well as the subscales (0.71–0.86). The removal of Items 4, 8, and 12 further improved the goodness of fit and Cronbach's α coefficients. Convergent validity was adequate with the EORTC‐QLQ‐C30. Conclusion Our analysis of the FACIT‐Sp‐12 revealed serious questions about three items and concerns about the Faith subscale. These problematic items deserve further attention so should be interpreted with care when using this scale. A future study could look into the items and test possible replacements.
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