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Erschienen in: Journal of Medicine and the Person 2/2013

01.08.2013 | Original Article

Spirituality as an essential element of person-centered compassionate care: a pilot training program for clinicians

verfasst von: Christina M. Puchalski, Raya Kheirbek, Ann Doucette, Toby Martin, Y. Tony Yang

Erschienen in: Journal of Medicine and the Person | Ausgabe 2/2013

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Abstract

Spirituality is an essential aspect of person-centered compassionate care. Data demonstrate that the majority of patients with serious or chronic illness would like their clinicians to address their spirituality and to provide spiritual care but that the majority of clinicians do not provide such care. Reasons cited include lack of training. This paper pilots and evaluates the impact of spirituality training on providers’ self-reported awareness and ability to address patient spirituality and to provide compassionate care. Thirty-eight clinicians were trained and 18 completed the pre/post-training evaluation surveys. The data demonstrated increased self-reported ability to perform spiritual screening (pre-training mean of 2.59, SD = 1.33 increased to post-training mean of 4.41, SD = 0.51). The self-reported ability to identify a patient’s spiritual resources of strength improved from pre-training mean of 3.27 (SD = 1.16) to post-training mean of 4.53 (SD = 0.83). Ability to identify a patient’s spiritual distress improved from pre-training mean of 2.81 (SD = 1.22) to post-training mean of 0.31 (SD = 0.60). The self-reported ability to chart the patient’s spiritual strengths improved from mean of 2.69 (SD = 1.25) to post-training 4.31 (SD = 0.48). The self-reported ability to discuss patients’ spiritual strengths and/or distress with others in the healthcare team increased from mean of 2.76 (SD = 1.30) to post-training mean of 4.47 (SD = 0.51). The self-reported ability to identify appropriate interventions increased from pre-training mean of 2.59 (SD = 1.23) to post-training mean of 4.24 (SD = 0.44). There were also improvements in self-reported abilities to: (a) establish appropriate boundaries with patients; (b) apply the concept of compassionate presence to clinical care; (c) understand the role of spirituality in professional life; and (d) identify ethical issues in inter-professional spiritual care. We conclude that it is possible to train clinicians to address patients’ spiritual needs and provide discipline appropriate spiritual care.
Literatur
1.
Zurück zum Zitat Puchalski CM, Cobb M, Rumbold B (eds) (2012) Oxford textbook of spirituality and healthcare. Oxford University Press, New York Puchalski CM, Cobb M, Rumbold B (eds) (2012) Oxford textbook of spirituality and healthcare. Oxford University Press, New York
2.
Zurück zum Zitat Brady MJ, Peterman AH, Fitchett G, Mo M, Cella D (1999) A case for including spirituality in quality of life measurement in oncology. Psychooncology 8:417–428PubMedCrossRef Brady MJ, Peterman AH, Fitchett G, Mo M, Cella D (1999) A case for including spirituality in quality of life measurement in oncology. Psychooncology 8:417–428PubMedCrossRef
3.
Zurück zum Zitat Albers G, Echteld MA, de Vet HC, Onwuteaka-Philipsen BD, van der Linden MH, Deliens L (2010) Content and spiritual items of quality-of-life instruments appropriate for use in palliative care: a review. J Pain Symptom Manage 40(2):290–300PubMedCrossRef Albers G, Echteld MA, de Vet HC, Onwuteaka-Philipsen BD, van der Linden MH, Deliens L (2010) Content and spiritual items of quality-of-life instruments appropriate for use in palliative care: a review. J Pain Symptom Manage 40(2):290–300PubMedCrossRef
4.
Zurück zum Zitat Puchalski CM, Ferrell B, Virani R, Otis-Green S, Baird P, Bull J, Chochinov H, Handzo G, Nelson-Becker H, Prince-Paul M, Pugliese K, Sulmasy D (2009) Improving the quality of spiritual care as a dimension of palliative care: the report of the consensus conference. J Palliat Med 12(10):885–904PubMedCrossRef Puchalski CM, Ferrell B, Virani R, Otis-Green S, Baird P, Bull J, Chochinov H, Handzo G, Nelson-Becker H, Prince-Paul M, Pugliese K, Sulmasy D (2009) Improving the quality of spiritual care as a dimension of palliative care: the report of the consensus conference. J Palliat Med 12(10):885–904PubMedCrossRef
5.
Zurück zum Zitat Astrow AB, Puchalsko CM, Sulmasy DP (2001) Religion, spirituality, and health care: social, ethical, and practical considerations. Am J Med 110:283–287PubMedCrossRef Astrow AB, Puchalsko CM, Sulmasy DP (2001) Religion, spirituality, and health care: social, ethical, and practical considerations. Am J Med 110:283–287PubMedCrossRef
6.
Zurück zum Zitat Sulmasy DP (2002) A biopsychosocial-spiritual model for the care of patients at the end of life. Gerontologist 42(3):24–33PubMedCrossRef Sulmasy DP (2002) A biopsychosocial-spiritual model for the care of patients at the end of life. Gerontologist 42(3):24–33PubMedCrossRef
7.
Zurück zum Zitat Lo B, Quill T, Tulsky J (1999) Discussing palliative care with patients (ACP-ASIM End-of-Life Care Consensus Panel). Ann Intern Med 130(9):744–749PubMedCrossRef Lo B, Quill T, Tulsky J (1999) Discussing palliative care with patients (ACP-ASIM End-of-Life Care Consensus Panel). Ann Intern Med 130(9):744–749PubMedCrossRef
8.
Zurück zum Zitat Phelps AC, Maciejewski PK, Milsson M, Balboni TA, Wright AA, Paulk ME, Trice E, Schrag D, Peteet JR, Block SD, Prigerson HG (2009) Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer. JAMA 301(11):1140–1147PubMedCrossRef Phelps AC, Maciejewski PK, Milsson M, Balboni TA, Wright AA, Paulk ME, Trice E, Schrag D, Peteet JR, Block SD, Prigerson HG (2009) Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer. JAMA 301(11):1140–1147PubMedCrossRef
9.
Zurück zum Zitat Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J (1999) Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med 159(15):1803–1806PubMedCrossRef Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J (1999) Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med 159(15):1803–1806PubMedCrossRef
10.
Zurück zum Zitat Sanghavi DM (2006) What makes for a compassionate patient-caregiver relationship? J Qual Patient Saf 32(5):283–291 Sanghavi DM (2006) What makes for a compassionate patient-caregiver relationship? J Qual Patient Saf 32(5):283–291
11.
Zurück zum Zitat Brady MJ, Peterman AH, Fitchett G, Mo M, Cella D (1999) A case for including spirituality in quality of life measurement in oncology. Psychooncology 8:417–428PubMedCrossRef Brady MJ, Peterman AH, Fitchett G, Mo M, Cella D (1999) A case for including spirituality in quality of life measurement in oncology. Psychooncology 8:417–428PubMedCrossRef
12.
Zurück zum Zitat Phelps AC, Maciejewski PK, Milsson M, Balboni TA, Wright AA, Paulk ME, Trice E, Schrag D, Peteet JR, Block SD, Prigerson HG (2009) Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer. JAMA 301(11):1140–1147 Phelps AC, Maciejewski PK, Milsson M, Balboni TA, Wright AA, Paulk ME, Trice E, Schrag D, Peteet JR, Block SD, Prigerson HG (2009) Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer. JAMA 301(11):1140–1147
13.
Zurück zum Zitat Balboni T, Balboni M, Paulk M et al (2011) Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life. Cancer 117(23):5383–5391 Balboni T, Balboni M, Paulk M et al (2011) Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life. Cancer 117(23):5383–5391
14.
Zurück zum Zitat McCord G, Gilchrist VJ, Grossman SD, King BD, McCormick JE, Oprandi AM, Schrop SL, Selius BA, Smucker WD, Weldy DL, Amorn M, Carter MA, Deak AJ, Hefzy H, Srivastava M (2004) Discussing spirituality with patients: a rational and ethical approach. Ann Fam Med 2(4):356–361PubMedCrossRef McCord G, Gilchrist VJ, Grossman SD, King BD, McCormick JE, Oprandi AM, Schrop SL, Selius BA, Smucker WD, Weldy DL, Amorn M, Carter MA, Deak AJ, Hefzy H, Srivastava M (2004) Discussing spirituality with patients: a rational and ethical approach. Ann Fam Med 2(4):356–361PubMedCrossRef
15.
Zurück zum Zitat Puchalski C, Guenther M (2012) Restoration and re-creation: spirituality in the lives of healthcare professionals. US National Library of Medicine National Institutes of Health 6(2):254–258 Puchalski C, Guenther M (2012) Restoration and re-creation: spirituality in the lives of healthcare professionals. US National Library of Medicine National Institutes of Health 6(2):254–258
17.
Zurück zum Zitat Kristeller JL, Zumbrun CD, Schilling RF (1999) “I would if I could”: how oncologists and oncology nurses address spiritual distress in cancer patients. Psychooncology 8(5):451–458PubMedCrossRef Kristeller JL, Zumbrun CD, Schilling RF (1999) “I would if I could”: how oncologists and oncology nurses address spiritual distress in cancer patients. Psychooncology 8(5):451–458PubMedCrossRef
19.
Zurück zum Zitat Puchalski CM (2007) Addressing spiritual issues with oncology patients. In: Angelos Peter (ed) Ethical issues in cancer patients. Springer, New York Puchalski CM (2007) Addressing spiritual issues with oncology patients. In: Angelos Peter (ed) Ethical issues in cancer patients. Springer, New York
20.
Zurück zum Zitat Puchalski CM, Larson DB (1998) Developing curricula in spirituality and medicine. Acad Med 73(9):970–974PubMedCrossRef Puchalski CM, Larson DB (1998) Developing curricula in spirituality and medicine. Acad Med 73(9):970–974PubMedCrossRef
21.
Zurück zum Zitat Puchalski CM (2006) Spirituality and medicine: curricula in medical education. J Cancer Educ 21:1CrossRef Puchalski CM (2006) Spirituality and medicine: curricula in medical education. J Cancer Educ 21:1CrossRef
22.
Zurück zum Zitat Puchalski CM, McSkimming S (2006) Creating healing environments. Health Prog 87(3):30–35PubMed Puchalski CM, McSkimming S (2006) Creating healing environments. Health Prog 87(3):30–35PubMed
23.
Zurück zum Zitat Puchalski C, Romer AL (2000) Taking a spiritual history allos clinicians to understand patients more fully. J Palliat Med 3(1):129–137PubMedCrossRef Puchalski C, Romer AL (2000) Taking a spiritual history allos clinicians to understand patients more fully. J Palliat Med 3(1):129–137PubMedCrossRef
24.
Zurück zum Zitat Borneman T, Ferrell B, Puchalski C (2010) Evaluation of the FICA tool for spiritual assessment. J Pain Symptom Manage 20(2):163–173CrossRef Borneman T, Ferrell B, Puchalski C (2010) Evaluation of the FICA tool for spiritual assessment. J Pain Symptom Manage 20(2):163–173CrossRef
25.
Zurück zum Zitat Puchalski C, Lunsford B (2008) White paper: the relationship of spirituality and compassion in health care. A Report for the Fetzer Institute Puchalski C, Lunsford B (2008) White paper: the relationship of spirituality and compassion in health care. A Report for the Fetzer Institute
Metadaten
Titel
Spirituality as an essential element of person-centered compassionate care: a pilot training program for clinicians
verfasst von
Christina M. Puchalski
Raya Kheirbek
Ann Doucette
Toby Martin
Y. Tony Yang
Publikationsdatum
01.08.2013
Verlag
Springer Milan
Erschienen in
Journal of Medicine and the Person / Ausgabe 2/2013
Print ISSN: 2035-9411
Elektronische ISSN: 2036-3877
DOI
https://doi.org/10.1007/s12682-013-0150-5

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