What do I do? Developing a taxonomy of chaplaincy activities and interventions for spiritual care in intensive care unit palliative care

Abstract

BackgroundChaplains are increasingly seen as key members of interdisciplinary palliative care teams, yet the specific interventions and hoped for outcomes of their work are poorly understood. This project served to develop a standard terminology inventory for the chaplaincy field, to be called the chaplaincy taxonomy.MethodsThe research team used a mixed methods approach to generate, evaluate and validate items for the taxonomy. We conducted a literature review, retrospective chart review, focus groups, self-observation, experience sampling, concept mapping, and reliability testing. Chaplaincy activities focused primarily on palliative care in an intensive care unit setting in order to capture a broad cross section of chaplaincy activities.ResultsLiterature and chart review resulted in 438 taxonomy items for testing. Chaplain focus groups generated an additional 100 items and removed 421 items as duplications. Self-Observation, Experience Sampling and Concept Mapping provided validity that the taxonomy items were actual activities that chaplains perform in their spiritual care. Inter-rater reliability for chaplains to identify taxonomy items from vignettes was 0.903.ConclusionsThe 100 item chaplaincy taxonomy provides a strong foundation for a normative inventory of chaplaincy activities and outcomes. A deliberative process is proposed to further expand and refine the taxonomy to create a standard terminological inventory for the field of chaplaincy. A standard terminology could improve the ways inter-disciplinary palliative care teams communicate about chaplaincy activities and outcomes.

An EAPC white paper on multi-disciplinary education for spiritual care in palliative care

“…Documentation of spirituality and SC in the healthcare setting supports the practice of SC in palliative care during the entire trajectory of illness. Initiatives aimed at standardising vocabulary in SC will facilitate this process [83,84]. While incorporating SC into the patient's care plan is encouraged for healthcare staff and SC workers, in many countries it is not currently a routine.…”

What Impact Do Chaplains Have? A Pilot Study of Spiritual AIM for Advanced Cancer Patients in Outpatient Palliative Care

“…10,16,17 However, without detailed descriptions or rigorous evaluations of chaplains’ activities, it is difficult to characterize or evaluate professional chaplains’ work. 9,11,17,18 …”

Development of the PC-7, a Quantifiable Assessment of Spiritual Concerns of Patients Receiving Palliative Care Near the End of Life

“…Chaplains working in palliative care address a wide variety of concerns of both patients and their loved ones. 18,19 The team felt that, for our initial effort, it was unrealistic to develop a model for spiritual assessment that addressed all of these situations; therefore, we developed a model for spiritual assessment that focused only on the patient who was receiving palliative care. Although family members are often the focus of a palliative care chaplains' attention, the model does not focus on assessing the spiritual needs of family members.…”

“…In our model, a score of 2 or 3 for any theme implies a level of unmet R/S concern or need that should be addressed in a care plan and follow-up care. 8,19 Our discussions led to several additional clarifications for assigning scores for unmet R/S concerns or needs. First, we assign a score that represents where the patient is at the end of the visit.…”