-.46***

1. Hopelessness -.46*** Religious Belief .69*** .17** ***p<.001, **p<.01. N = 271 Depression CURRENT RESEARCH AND TRENDS IN SPIRITUAL CARE George Fitchett, DMin, PhD, BCC Department of Religion, Health and Human Values Rush University Medical Center, Chicago, IL and Katherine M. Piderman, PhD, BCCDepartment of Chaplain Services Mayo Clinic, Rochester, MN

2. Outline • Why Care About Research • Three Approaches to Research • Structure • Chaplain-Patient Ratios • Process • Productivity • Screening for Spiritual Distress • Outcomes • Quality of Life • Recovery • Satisfaction • Treatment Preferences & Cost • Implications, Applications, Next Steps • Discussion Mowat, 2008

3. Why Should Chaplains Care about Research? • Chaplains bring a unique perspective that can inform research design, application, interpretation, and application. • Research is an opportunity to build relationships with others on the health care team. • Presentations and publications based on research can be “prophetic” in bringing spiritual and religious issues forward.

4. Measures of Structure: Chaplain-Patient Ratios Flannelly et al., 2004

5. Measures of Process: What Chaplains Do Chaplains interventions during initial visits (MSKCC). From Flannelly et al, 2003

6. Measures of Process:Screening for Religious Struggle A woman in her fifties with advanced cancer told a chaplain, “Why? Why me? I just can’t figure it out. And I get so depressed that I just want to give up on life altogether, you know? And I’m so very angry at God. So angry. I refuse to speak to Him. You know what I mean?” From: Fitchett and Roberts, In the Garden with Andrea, 2004

7. Harmful Effects Associated with Religious Struggle

8. Prevalence of Spiritual Distress in Palliative Care Patients 23% with distress in 3+ Chaplain ratings of spiritual distress for 113 palliative care in-patients at MD Anderson. Hui et al., 2011

9. 3 Actions: • Refer for spiritual assessment re: possible RS struggle. • Spiritual care requested, make referral. • No action: no indication of RS struggle, no interest in spiritual care. Fitchett & Risk, 2009

10. Are you experiencing spiritual pain right now? • Are you experiencing spiritual pain right now? • Spiritual pain is a pain deep in your soul (being) that is not physical • How would you rate your overall spiritual pain • 0 (none) – 10 (worst)?

11. Rummans et al 2006

13. Patient’s Ratings of Reasons for Wanting to See a Chaplain (n=1,591)

14. Measures of Outcomes: Satisfaction, Other Studies

15. Measures of Outcome: QoL (& treatment preferences & cost of care) Avg QoL= 19, SD=7.9 N=299 patients; Balboni et al, 2010

16. Hopelessness -.46*** Religious Belief .69*** .17** ***p<.001, **p<.01. N = 271 Depression Implications, Applications, Next Steps Health Care Chaplaincy Improving our Care and Making our Case Through Research

17. Implications of Screening for Spiritual Pain

18. Cancer Program Standards 2012: Ensuring Patient-Centered Care http://www.facs.org/cancer/coc/cps2011.html Pirl W et al., 2013. Available at http://www.apos-society.org/

19. Implications for Clinical Practice

20. Next Steps in Chaplaincy Research: Begin with Case Studies

21. Next Steps: Research Literacy, Chaplain Education and Certification • Need to teach research literacy skills in CPE residency programs • Create research journal clubs in chaplaincy departments • Demonstrate research literacy for chaplaincy certification Fitchett et al , 2012

22. Time for Discussion George Fitchett, DMin, PhD, BCC george_fitchett@rush.edu Our research website: www.rushu.rush.edu/rhhv click on Research in Religion, Health & Human Values Kate Piderman, PhD, BCC piderman.katherine@mayo.edu