This survey provides the first description of chaplains working in PC across the United States. We describe chaplains' critical role in attending to relationship building, care for the dying, and goals of care conversations. Our results highlight how the chaplains' level of involvement in PC affects the content of their visits. Our study suggests that when chaplains are more involved in PC teams, they provide more comprehensive support to PC patients and their families.
Self- and family management (SFM) refers to patients’ and family caregivers’ activities to co-manage illness. Two barriers to SFM are low palliative care literacy and lack of goals of care communication, which potentially result in SFM activities that are unsupportive of patients’ goals. Managing Cancer Care: A Caregiver’s Guide (MCC-CG) aims to improve palliative care literacy and communication within a SFM training program. In this pilot randomized trial, we enrolled breast cancer family caregivers and collected data at 0, 1, and 3 months on palliative care literacy, SFM engagement, communication, transitions management, uncertainty, caregiver burden, and caregiver competence/personal gain. Participants ( n = 35) had a mean age of 54 (range: 18–81) and were 66% white and 34% racial/ethnic minorities. Intervention participants improved their palliative care literacy and SFM engagement, reduced uncertainty and caregiver burden, increased competence/personal gain, and had more goals of care conversations over time. MCC-CG has preliminary efficacy, warranting further study.
BackgroundThe prevalence of burnout and distress among palliative care professionals has received much attention since research suggests it negatively impacts the quality of care. Although limited, research suggests low levels of burnout or distress among healthcare chaplains; however, there has been no research among chaplains working in specific clinical contexts, including palliative care.ObjectiveThis study explored the distress, self-care, and debriefing practices of chaplains working in palliative care.MethodExploratory, cross-sectional survey of professional chaplains. Electronic surveys were sent to members of four professional chaplaincy organizations between February and April 2015. Primary measures of interest included Professional Distress, Distress from Theodicy, Informal Self-care, Formal Self-care, and debriefing practices.ResultMore than 60% of chaplains working in palliative care reported feeling worn out in the past 3 months because of their work as a helper; at least 33% practice Informal Self-care weekly. Bivariate analysis suggested significant associations between Informal Self-care and both Professional Distress and Distress from Theodicy. Multivariate analysis also identified that distress decreased as Informal and Formal Self-care increased.Significance of resultsChaplains working in palliative care appear moderately distressed, possibly more so than chaplains working in other clinical areas. These chaplains also use debriefing, with non-chaplain palliative colleagues, to process clinical experiences. Further research is needed about the role of religious or spiritual beliefs and practices in protecting against stress associated with care for people at the end of life.
as they become more fragile and in many cases require increasing resources, including clinic and emergency department visits, home services, and hospitalizations. This session will provide a general introduction to several of the newer payment mechanisms emerging as part of the Affordable Care Act, with particular emphasis on integrated practice units (IPUs) and bundled payments. The session will also highlight the development of a bundled payment project at a large, greater-than-900-bed acute-care academic institution that incorporated palliative and supportive care interventions into the IPU care model. The session will be presented by members of the interdisciplinary team that developed this model, including palliative care and pulmonary physicians, a nurse practitioner, and a member of the healthcare system leadership team. Results from the first year of the COPD bundled payment project will be highlighted, including changes in medical care management, order sets, automated tracking and referrals for patients in the bundle, consultation with palliative and supportive care, involvement of home care and pulmonary rehabilitation, and initial financial results from the first cohort of patients. ObjectivesDescribe models of conflict resolution styles and reflect about one's own typical approach to conflict resolution. Identify how one's own personal conflict resolution style may lead to pitfalls in communication with team members who may have different approaches to conflict resolution. Identify reasons for, and potential sources of, conflict among members of an interdisciplinary team. Building a strong integrated team requires careful planning, commitment, and constant nurturing. This session will explore the development of a new palliative care interdisciplinary team, including the challenges and opportunities the team faced as it expanded. An effective, coordinated team must have an efficient mechanism for exchange of information. At the minimum, it requires space and a regular time to meet to share ideas and learn from each other. Given the team members' mixture of skills and professional backgrounds, interdisciplinary collaboration is complex. A diversity of views and differences of opinion are inevitable. Conflict is both necessary and desirable in order for the team to grow and improve. Our team made a commitment to seek formal team training in order to solidify and strengthen our collaboration. During this session we will share what we learned, including writing a program mission statement, defining team core values, identifying our own personal conflict resolution style using validated instruments, and exploring strategies to effectively address conflict using Kerry Patterson's ''Crucial Conversations Model'' as a guide. We will discuss the benefits of conflict on an interdisciplinary team by using cases that illustrate how conflict can encourage innovation, the acquisition of new knowledge, and creative problem solving. Practical conflict resolution skills will be applied to common disagreements among me...
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