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End-of-life spiritual care at a VA medical center: Chaplains' perspectives

Published online by Cambridge University Press:  22 May 2012

Bei-Hung Chang ,
Nathan R. Stein ,
Kelly Trevino ,
Max Stewart ,
Ann Hendricks  and
Lara M. Skarf
Bei-Hung Chang*
Affiliation:
VA Boston Healthcare System, Boston, Massachusetts Boston University School of Public Health, Boston, Massachusetts
Nathan R. Stein
Affiliation:
VA Boston Healthcare System, Boston, Massachusetts
Kelly Trevino
Affiliation:
Dana Farber Cancer Institute, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Max Stewart
Affiliation:
VA Boston Healthcare System, Boston, Massachusetts
Ann Hendricks
Affiliation:
VA Boston Healthcare System, Boston, Massachusetts
Lara M. Skarf
Affiliation:
VA Boston Healthcare System, Boston, Massachusetts
*
Address correspondence and reprint requests to: Bei-Hung Chang, 150 S. Huntington Ave. (152H), Boston, MA 02130. E-mail: bhchang@bu.edu
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Abstract

Objective:

Spiritual care is an essential component of quality palliative care. Recognizing the importance, the Department of Veterans Affairs (VA) mandates the inclusion of chaplains in a palliative care consult team (PCCT). The purpose of this study is to explain the process and content of spiritual care provided in a VA Medical Center from chaplains' perspectives.

Method:

Five Christian chaplains who provide care to patients at end of life were interviewed. Each interview was recorded and transcribed. Analysis based on the grounded theory was used to identify themes from each interview question.

Results:

The PCCT in this study appeared to have a strong referral and communication system in which every palliative care patient was seen by a chaplain and the care plan was discussed with an interdisciplinary team. Chaplains reported providing a range of services, which addressed religious, spiritual, emotional, family, and illness concerns. Chaplains were aware of the unique spiritual needs of veterans, including working through guilt for killing in war and requiring forgiveness. Chaplains' ideas for improvement of spiritual care services included increasing time to provide care, providing bereavement care and support to families, and adding chaplains with different religious backgrounds. Chaplains reported how their own spirituality influenced the care they provided.

Significance of results:

Spiritual care in the VA can include a range of services and should consider the unique needs of the veteran population. Future studies can build upon our findings from chaplains to learn about the perspectives of patients, family, and other healthcare providers of spiritual care. This information would allow identification of strengths of current spiritual care practices and areas for care improvement, and ultimately could improve the well-being of patients at the end of life.

Keywords

End of lifeSpiritual careChaplainsVeterans
Type
Original Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 4 , December 2012 , pp. 273 - 278
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

Anonymous, VHA Directive 2008–066. http://www1.va.gov/VHAPUBLICATIONS/ViewPublication.asp?pub_ID=1784.Google Scholar
Balboni, T.A., Vanderwerker, L.C., Block, S.D., et al. (2007). Religiousness and spiritual support among advanced cancer patients and associations with end-of-life treatment preferences and quality of life. Journal of Clinical Oncology, 25, 555–560.CrossRefGoogle ScholarPubMed
Fitchett, G., Rybarczyk, B., DeMarco, G.A., et al. (1999). The role of religion in medical rehabilitation outcomes: A longitudinal study. Rehabilitation Psychology, 44, 333–353.Google Scholar
Fletcher, C.E. (2004). Health care providers' perceptions of spirituality while caring for veterans. Qualitative Health Research, 14, 546–561.CrossRefGoogle ScholarPubMed
Grassman, D. (2007). Wounded warriors: Their last battle. Home Healthcare Nurse, 25, 299–304.Google Scholar
Koenig, H.G., Pargament, K.I., Nielsen, J. (1998). Religious coping and health status in medically ill hospitalized older adults. Journal of Nerverous and Mental Disease, 186, 513–521.Google Scholar
Litz, B.T., Stein, N., Delaney, E., et al. (2009). Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clinical Psychology Review, 29, 695–706.Google Scholar
Pargament, K.I., Koenig, H.G., Tarakeshwar, N. et al. (2001). Religious struggle as a predictor of mortality among medically ill elderly patients: A 2-year longitudinal study. Archive of Internal Medicine, 161, 1881–1885.Google Scholar
Puchalski, C., Ferrell, B., Virani, R., et al. (2009). Improving the quality of spiritual care as a dimension of palliative care: The report of the Consensus Conference. Journal of Palliative Medicine, 12, 885–904.Google Scholar
Puchalski, C.M. (2007). Spirituality and the care of patients at the end-of-life: an essential component of care. Omega (Westport), 56, 33–46.Google Scholar
Strang, S. & Strang, P. (2002). Questions posed to hospital chaplains by palliative care patients. Journal of Palliative Medicine, 5, 857–864.CrossRefGoogle ScholarPubMed
Strauss, A. & Corbin, J. (1990). Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage.Google Scholar
Wright, M.C. (2001). Chaplaincy in hospice and hospital: Findings from a survey in England and Wales. Palliative Medicine, 15, 229–242.Google Scholar