Placing religion and spirituality in end-of-life care.
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Ethics, Medical↗
Biomedical subjects
L VandeCreek
Publications and source records attributed to L VandeCreek.
Should physicians prescribe religious activities?
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Attitude to Health↗
Risk management and life-threatening patient behaviors.
This article reviews the legal and ethical issues that arise in the treatment of patients who may pose a threat to harm themselves or others. The recent practice of developing empirically validated treatments has not yet been applied to the diagnosis and treatment of patients who present an imminent danger of harm to themselves or others. Instead, psychologists must follow standards that come primarily from court cases or statutes. Although these standards have some degree of commonality across North America, psychologists are encouraged to be informed about local laws and court cases.
Child↗
The unique benefits of religious support during cardiac bypass surgery.
Compares the self-reports of family members waiting during the cardiac artery grafting surgery of a loved one and explores whether they make distinctions between the contributions of nonreligious and religious support. Results from regression analyses suggests that the use of religious sources of support was associated with both more positive religious and nonreligious psychosocial adjustment scores after the influences of nonreligious support were statistically removed. Notes that among the 13 religious support activities identified, family members reported using prayer most frequently. Concludes that using religious support sources to cope with this surgically related stress is associated with distinct subjective benefits beyond those contributed by nonreligious sources.
Adaptation, Psychological↗
Use of alternative therapies among breast cancer outpatients compared with the general population.
CONTEXT: Breast cancer is the second largest cause of cancer death among women in the United States. Given the fear associated with its morbidity and mortality, patients might seek a variety of alternative treatments. No careful description of breast cancer patients' interest in or use of these therapies appears to exist. OBJECTIVE: To create a profile that describes interest in and use of a wide variety of alternative therapies available to breast cancer outpatients; to gather data concerning related issues such as the number of appointments for these therapies, their cost, and reimbursement patterns; and to compare these findings with a published profile of the general public. DESIGN: An interview gauging patients' interest in and use of alternative treatments followed by 2 questionnaires concerning (1) mental adjustment to the cancer experience and (2) personal growth in response to the encounter with cancer. SETTING: Suburban breast cancer clinic in a Midwestern university medical center. PARTICIPANTS: 112 female breast cancer outpatients. MAIN OUTCOME MEASURES: Rankings of interest in and use of alternative treatments by the patients interviewed. RESULTS: The 3 most frequently used alternative therapies were prayer (76%), exercise (38%), and spiritual healing (29%). Comparison with the general public profiles revealed that breast cancer patients more frequently used 17 specific alternative therapies. The largest increases were found in the use of prayer (51% increase), spiritual healing (25% increase), and megavitamins (23% increase). Only chiropractic was used substantially more often among the general population. CONCLUSION: Breast cancer outpatients involved in conventional treatment are more likely to use a wide range of alternative therapies than is the general public. It is likely that the mortality and morbidity associated with breast cancer motivates this increased use.
Adult↗
Collaboration between nurses and chaplains for spiritual caregiving.
OBJECTIVES: To discuss three ambiguities that may accompany nurse-chaplain collaboration in providing spiritual care: confusion about the meaning of "spiritual" and related terms, spiritual assessment and the referral process, and the role of clergy. DATA SOURCES: Review and research articles related to nursing and pastoral care, and documented standards. CONCLUSION: Effective nurse-chaplain collaboration is necessary (especially considering current health care system changes) to provide adequate spiritual care. Additionally, the increased involvement of both nurses and chaplains in ethical issues is likely to make nurse-chaplain collaboration increasingly important. IMPLICATIONS FOR NURSING PRACTICE: Nurses must collaborate with chaplains and relate to clergy to provide spiritual care for cancer patients and families. Knowledge of assessment differences between nurses and chaplains, terminology, and role of clergy will enhance this collaboration.
Guidelines as Topic↗
Religious support from parish clergy for hospitalized parishioners: availability, evaluation, implications.
Reports the results of interviews with a random sample (N = 500) of hospital patients responding to the following questions: What percentage of hospital patients consider themselves part of a church or synagogue? How many patients identify a specific parish clergy or some other source who could provide them pastoral support? How many patients received pastoral support during hospitalization from clergy or some other person, and by visit or phone call (excluding hospital chaplains)? How do hospital patients evaluate the helpfulness of these pastoral visits? Discusses the results of the survey, implications for pastoral caregivers, and suggests future research possibilities.
Chaplaincy Service, Hospital↗
Ministry of hospital chaplains: patient satisfaction.
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Chaplaincy Service, Hospital↗
Using INSPIRIT to conduct spiritual assessments.
Notes that pastoral caregivers are increasingly interested in spiritual assessment of patients. Reports results when the Index of Core Spiritual Experiences (INSPIRIT) is used for assessment with medical and surgical outpatients as well as patient family members (N = 371). Reports subscales within the instrument, mean scores, and notes that 80% of all respondents reported at least one experience which they regarded as spiritual.
Factor Analysis, Statistical↗
Variables that predict interest in and the completion of living wills.
Observes that although chaplains and congregational pastors frequently advocate the completion of advance directives, including living wills, the research reports that only 5 to 15% of the general population have completed the instrument. Asks, Why have so few completed it? Reports on research which suggests that age is the only statistical predictor of whether a person possesses a completed living will when measured against social and personality variables, including levels of social support, fear of dying, religiousity, self-esteem, and trust in physicians. Concludes that it is likely that age is a proxy variable which represents changes in attitudes, beliefs, and thoughts which tend to occur as persons grow older.
Advance Directives↗
The impact of religious faith and practice on patients suffering from a major affective disorder: a cost analysis.
Presents empirical data showing the relationship between religious beliefs and practices and lengths of stay in the hospital for patients suffering from one form of mental illness. Includes a spiritual injury scale which measures guilt, anger or resentment, sadness/grief, lack of meaning, feeling God/life has treated one unfairly, religious doubt, and fear of death. Shows in statistical form the relationship between these spiritual injuries and length of stay in the hospital. Indicates that spiritual injury issues are positively associated with longer lengths of hospital stay and that an inverse relationship exists between religious faith as measured by church attendance and cost for health care.
Cost-Benefit Analysis↗
Assessment of pastoral needs among medical outpatients.
Reports research findings on samples of hospital outpatients, hospital inpatients, and well persons from the community in an attempt to explore the content and extent of pastoral needs among medical/surgical outpatients. Analyzes and presents statistical data which lead to the conclusion that the spiritual needs of outpatients manifest greater similarity to healthy persons in the community than to hospital inpatients. Notes limitations of the study and discusses praxis implications for chaplains.
Adult↗
Psychometric characteristics of the Headache-Specific Locus of Control scale.
Martin and colleagues have described their development of a Headache-Specific Locus of Control scale (HSLC) which contains 11 items for each of its three subscales: internal, health care professional, and chance orientations. In this replication study, we gathered data from patients who came to a Headache Clinic in a medical center (n = 151) and from a comparison sample (n = 192). Factor analysis and alpha coefficients were similar to those reported by Martin. Only small correlations were found between the subscale scores although some of them were statistically significant. This suggests that the HSLC is a psychometrically competent instrument. Additionally, mean scores of its three subscales differentiated the patient population from those whose headaches were less severe and thus did not seek help.
Adult↗
Measuring the spiritual needs of hospital patients and their families.
Uses four psychometric instruments in an attempt to measure the spiritual needs of general hospital patients, family members, and persons from the community. Infers that the data suggest that family members tend to be more involved in a search for meaning than are patients and community persons. Discusses implications of the results for pastoral caregivers.
Chaplaincy Service, Hospital↗
The value of hospital chaplains: patient perspectives.
Reports the results of a questionnaire mailed to insurance claimants (N = 2480) recently discharged from a hospital. Analyzes the results and concludes from the data that patients place high value on pastoral services. Suggests that both hospital administrators and chaplains make sure that adequate attention be given to serving patient families, long-stay and repeated admission patients, and to the patients' demonstrated need for frequent visits, particularly in these times of rapid changes in condensing hospital stays.
Chaplaincy Service, Hospital↗
Evaluation of the hospital chaplain's pastoral care: Catholic and Protestant differences.
Reports the results of a questionnaire survey of Roman Catholic and Protestant insurance claimants (N = 445) who were asked to evaluate their hospital stays in terms of pastoral care, social services, and patient representatives. Discusses the results--including a ranking of the levels at which spiritual needs were met--and offers guiding questions for future research.
Adult↗
Understanding physicians: an educational history and brief practice profile.
Physicians experience years of scientific training and practice with emphasis on objectivity, personal sacrifice in favor of career, struggle to survive demands/pressures, and the need to save life. These themes differ significantly from those experienced by chaplains. Chaplains can strengthen their relationships with physicians when they appreciate this thematic difference. This article describes the process of medical education, including residency, and points out selected contradictions within which medical practice must work.
Attitude of Health Personnel↗
Patient and family perceptions of hospital chaplains.
While most hospitals provide chaplaincy services for patients, families, and staff, these services are seldom studied and their contribution is poorly understood. A questionnaire created by the College of Chaplains of the American Protestant Health Association was mailed by an insurance company to patients recently dismissed from the hospital, requesting evaluation of three non-medical services (social services, chaplaincy, and patient representatives) and how well the spiritual needs for support/counseling, prayer, and sacraments were met. Responses revealed that, in comparison to the other two non-medical services, patients receive more visits from chaplains, evaluate these visits as more important (p less than 0.000), and report that these visits meet their expectations more highly (p less than 0.000). Regression analyses demonstrate that when the chaplain meets the patient's need for support/counseling, the respondent is more likely to select the hospital again (p = 0.04) and recommend it to others (p = 0.05). Similarly, when chaplains meet the family's need for support/counseling, the respondent is likely to choose the hospital again. Since chaplains clearly make an important contribution to patients, their families, and the hospital, administrators should review the adequacy of their chaplaincy services in the light of these data.
Attitude to Health↗