The Chaplain Family Project: Development, Feasibility, and Acceptability of an Intervention to Improve Spiritual Care of Family Surrogates

Torke, Alexia M.; Maiko, Saneta; Watson, Beth Newton; Ivy, Steven S.; Burke, Emily S.; Montz, Kianna; Rush, Sarah A; Slaven, James E.; Kozinski, Kathryn; Axel-Adams, Robyn; Cottingham, Ann H.

doi:10.1080/08854726.2019.1580979

Cited by 11 publications

(13 citation statements)

References 46 publications

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“…Early intervention by chaplains who are well-integrated in their ICU team may assist patients and their loved ones in coming to terms with grave illness and making difficult treatment decisions. 42 In addition to providing spiritual and emotional comfort these interventions may affect other outcomes such as ICU LOS. Further well-designed studies including randomized trials are needed to explore these possible benefits of chaplain care in the ICU.…”

Section: Discussionmentioning

confidence: 99%

Chaplaincy Care in the MICU: Examining the Association Between Spiritual Care and End-of-Life Outcomes

Labuschagne

Torke

Grossoehme

et al. 2021

Am J Hosp Palliat Care

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Background: Seriously ill patients admitted to the Intensive Care Unit (ICU) experience severe spiritual and existential distress. Patients’ surrogate decision makers face the burden of making complex decisions about their loved ones’ care. Experienced chaplains may play a role in assisting with decision-making, possibly by aligning patients’ values and wishes with treatment plans and avoiding non-beneficial aggressive measures. Objectives: To identify associations between chaplaincy care and length of stay (LOS) in the medical ICU (MICU). Methods: This was a retrospective observational study of usual spiritual care in the adult MICUs of 4 medical centers in the United States over a 3-month period. Inclusion criteria were death in the MICU or discharge to palliative care or hospice. Measures included medical, treatment, and spiritual care information. Through bivariate and multivariable analyses associations between spiritual care and LOS were examined. Results: In multivariable analysis of the 254 patients, receiving spiritual care was associated with an increased likelihood of being in a higher LOS tertile (adjusted odds ratio = 2.94, p < .001). In post hoc bivariate analysis, cases receiving spiritual care within the first 48 hours of MICU admission revealed a trend toward lower LOS (p = .181). Conclusion: Spiritual care in the MICU was associated with longer LOS. Early intervention by chaplains who are well-integrated in the ICU may assist patients and their loved ones in coming to terms with grave illness and making difficult treatment decisions. Further well-designed studies of spiritual care interventions that may affect outcomes are needed.

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Section: Discussionmentioning

confidence: 99%

Chaplaincy Care in the MICU: Examining the Association Between Spiritual Care and End-of-Life Outcomes

Labuschagne

Torke

Grossoehme

et al. 2021

Am J Hosp Palliat Care

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“…Earlier and proactive chaplaincy involvement in the patient’s ICU stay is an important potential area for improvement. The Spiritual Care Assessment and Intervention Framework was developed to provide support to surrogates in the ICU 4 and models a way in which chaplains can improve their quality of care and integration into essential activities in the ICU setting. Although the role chaplains can play in supporting decision-making in the ICU was emphasized recently, 11 the present study found such activity was infrequent.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] In addition, these patients' surrogate decision makers, often family members or close friends, experience challenges of their own, including emotional and spiritual distress and the need to make complex medical decisions on behalf of the patient. 4,5 The National Consensus Project Guidelines include spiritual care for hospice and palliative care patients and families. 6 American College of Critical Care Medicine Task Force guidelines recommend the provision of spiritual care to patients and families in the ICU.…”

Section: Introductionmentioning

confidence: 99%

Chaplaincy Care in the MICU: Describing the Spiritual Care Provided to MICU Patients and Families at the End of Life

Labuschagne

Torke

Grossoehme

et al. 2020

Am J Hosp Palliat Care

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Background: Gravely ill patients admitted to the intensive care unit (ICU), and their families experience acute spiritual and existential needs and often require complex decisions about their care. Little is known about what constitutes chaplaincy care for patients or families in ICUs. Chaplains report that participation in medical decision-making is part of their role. Objective: To describe the spiritual care provided to patients and their families in the ICU. Methods: This was a retrospective observational study of spiritual care for patients and families in the medical ICUs (MICUs) at 4 medical centers over a 3-month period. Inclusion criteria were death in the MICU or discharge to palliative care or hospice. Measures included medical, treatment, and spiritual care information (number of visits, length of visit, chaplain categories, and type of spiritual care provided). Results: Of the 254 patients, 197 (78%) received a total of 485 spiritual care visits. Seventy-seven percent of visits included provision of emotional/spiritual support; only 15% included decision-making support such as family meetings or goals-of-care conversations. The proportion receiving spiritual care increased as patients neared death or discharge. Staff chaplains were involved in goals-of-care conversations to a greater extent than student or part-time chaplains ( P < .05). Conclusion: Spiritual care was provided to most patients and/or families at the end of life. Low chaplain involvement in decision-making in the MICU suggests opportunities to improve chaplains’ contributions to ICU care.

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“…Additionally, the majority of prior research studies have been limited to patients and have not given attention to the expectations or level of satisfaction the patients' loved ones have of chaplain services. There are few studies that do specifically address the needs of family members (Johnson et al, 2014;Torke et al, 2019;Wall, Engelberg, Gries, Glaven, & Curtis, 2007). This study used the term "loved ones" which includes those visitors/friends, family members, and significant others of the patients admitted to the hospital.…”

Section: Introductionmentioning

confidence: 99%

Patients’ and Loved Ones’ Expectations of Chaplain Services

Muehlhausen

Foster

Smith

et al. 2021

Journal of Health Care Chaplaincy

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A study assessing the expectations patients and loved ones have of hospital chaplains was conducted at Ascension St. Vincent Indiana hospitals. In-person interviews were conducted with 452 patients and loved ones during an inpatient stay. The survey instrument was a modified version of a survey developed by Dr. Katherine Piderman of the Mayo Clinic. Participants answered questions regarding demographics, awareness of availability, expectations of visits, reasons for wanting to see a chaplain and gave feedback regarding visits if they had seen a chaplain. Results showed that patients and loved ones value chaplains with 93% saying they wanted a chaplain visit. This study was unique in seeking feedback from loved ones as well as patients. It may be equally important to reach out to loved ones during times of crisis when patients themselves are in surgery or sedated and loved ones are experiencing heightened anxiety.

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The Chaplain Family Project: Development, Feasibility, and Acceptability of an Intervention to Improve Spiritual Care of Family Surrogates

Cited by 11 publications

References 46 publications

Chaplaincy Care in the MICU: Examining the Association Between Spiritual Care and End-of-Life Outcomes

Chaplaincy Care in the MICU: Examining the Association Between Spiritual Care and End-of-Life Outcomes

Chaplaincy Care in the MICU: Describing the Spiritual Care Provided to MICU Patients and Families at the End of Life

Patients’ and Loved Ones’ Expectations of Chaplain Services

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