Evidence-Based Healthcare Chaplaincy

A Research Reader

George Fitchett, Kelsey White, Kathryn Lyndes

• Publisher: Jessica Kingsley Publishers
• Year: 2018
• ISBN:
  9781784509231
• Topic: Theology & Religion
• Subtopic: Christian Ministry

Research literacy is now a requirement for Board-Certified chaplains in the US and a growing field in the UK. This reader gives an overview and introduction to the field of healthcare chaplaincy research. The 21 carefully chosen articles in this book illustrate techniques critical to chaplaincy research: case studies; qualitative research; cross-sectional and longitudinal quantitative research, and randomized clinical trials. The selected articles also address wide-ranging topics in chaplaincy research for a comprehensive overview of the field.

To help readers engage with the research, each article includes a discussion guide highlighting crucial content, as well as important background information and implications for further research. This book is the perfect primary text for healthcare chaplaincy research courses, bringing together key articles from peer-reviewed journals in one student-friendly format.

SECTION 1

HEALTHCARE
CHAPLAINS: WHERE
THEY WORK AND
WHAT THEY DO

Introduction

Research has provided snapshots of what healthcare chaplains do and where they practice. Section 1 begins with an overview of where chaplains work and moves more specifically into the components of their care. We encourage you to consider a multidisciplinary conversation as you work through the Reader; a rich variety of perspectives will inform the conversation. For example, the implication of the chaplain taxonomy (Massey et al. 2015) may be different for a physician than for a chaplain. The perspectives of non-chaplain colleagues will strengthen chaplain practice and research, and the insights of chaplains will strengthen the holistic care provided by other clinicians to patients and families.

The first article by Cadge, Freese, and Christakis (2008) provides an overview of the proportion of hospitals in the US with chaplaincy departments. Then, a case study by Nolan (2016) takes an in-depth look at chaplaincy care for those who identify as non-religious. Articles 3 and 4 offer different perspectives on the language we use to describe chaplain activities. One perspective arises out of the work of chaplain-researchers (Massey et al. 2015), while the other comes from a multidisciplinary team reviewing chart notes (Johnson et al. 2016). Finally, the section concludes with two articles focused on spiritual screening and assessment. King et al. (2017) and Monod et al. (2010a) will help you think through the differences between these activities and initiate conversation about their clinical application. As the profession shifts from a paradigm focused on presence to a paradigm focused on interventions and outcomes, the work of chaplains will need to move past the simple identification of spiritual distress to a more nuanced assessment of the type and degree of spiritual distress.

As you read, also pay attention to the study designs and the amount of evidence each article offers. The design type of each study determines the amount of evidence or generalizations one can take from the results. Cross-sectional studies (measuring one point in time) can help you identify relationships between variables while randomized control trials (see Article 16) permit stronger causal inferences. Within Section 1, King et al. (2017) used a study design that provides some of the most substantial evidence. When a study provides stronger evidence, one can then begin to consider its wider application and generalization.

Several themes emerge throughout the articles in Section 1. First, consider the theme of spiritual pain and how chaplains identify unmet spiritual need. Section 1 articles that attend to spiritual pain focus on its prevalence and how best to identify it. For example, King et al. (2017) sought the best method for screening for distress, and Monod et al. (2010a) created a validated assessment of spiritual distress for use with elderly rehabilitation patients. When studying the articles by Massey et al. (2015) and Johnson et al. (2016), consider not only what their results say about the specific work chaplains do but also about the intensity of chaplaincy treatment in specific patient populations. People receiving care from chaplains are often in the midst of significant life events, and these articles in Section 1 help us better understand how to identify the spiritual needs associated with those events.

A second theme in the articles is refining the language of chaplaincy care. The profession, through research and practice, is still working to identify the best way to describe its role. For example, Cadge et al. (2008) indirectly explore the language of chaplaincy organizational structures, and Nolan (2016) begins to delve theologically into the mystical connection that can occur in relationship with another. Some chaplains refer to this connection as a ministry of presence. Through different avenues, each of these articles attempts to bridge a gap between the practice of routine chaplain care and the language used to communicate routine chaplain care. As you will see, and as discussed in the Introduction, the articles look at routine care in different ways, and research helps us refine that language. We are clarifying what we do and how we communicate about it in a multidisciplinary environment.

The articles in Section 1 also highlight the paradigm shift within the profession. The model of intentional care that includes a plan focused on changing an outcome is quite different from chaplaincy care informed by a paradigm focused on pastoral presence (Cadge 2012, see especially Chapter 4). Research will need to continue to address how the structures (e.g., departmental organization, clinical assignments, on-call coverage) of chaplaincy work impact patients, families, and staff. I...