Bioethical Issues and Health Care Chaplaincy in Aotearoa New Zealand

This paper summarizes survey and interview results from a cross-sectional study of New Zealand health care chaplaincy personnel concerning their involvement in multiple bioethical issues encountered by patients, families and clinical staff within the health care context. Some implications of this study concerning health care chaplaincy, ecclesiastical institutions, health care institutions and government responsibilities are discussed and recommendations presented.     

Pain Control and Chaplaincy in Aotearoa New Zealand

This paper summarizes the results of 100 New Zealand health care chaplains with regard to their involvement in issues concerning pain control within the New Zealand health care context. Both quantitative (via survey) and qualitative methods (in-depth interviewing) were utilized. The findings of this study indicated that approximately 52 % of surveyed hospital chaplains had provided some form of pastoral intervention directly to patients and/or their families dealing with issues concerning pain and that approximately 30 % of hospital chaplains had assisted clinical staff with issues concerning pain. NZ chaplaincy personnel involved in pain-related issues utilized a number of pastoral interventions to assist patients, their families and clinical staff. Differences of involvement between professionally stipended hospital chaplains and their volunteer chaplaincy assistants are noted, as are the perspectives of interviewed chaplains about their pastoral interventions with issues relating to pain. Some implications of this study with respect to chaplaincy utility, training and collaboration with clinical staff are noted, as are comparisons with international findings.     

Correctional Services and Prison Chaplaincy in Australia: An Exploratory Study

This paper summarizes an exploratory study undertaken to consider the work of Australian chaplaincy personnel ministering to prisoners within correctional facilities. This qualitative research was not concerned with specific correctional institutions per se, but predominantly about the perspectives of chaplains concerning their professional contribution and issues they experienced while trying to provide pastoral care to prisoners. Data from a single-focus group indicated that prison chaplains were striving to fulfill religious and spiritual duties according to national and international standards for the treatment of prisoners. Given various frustrations identified by participants, that either impeded or thwarted their professional role as chaplains, a number of improvements were subsequently identified in order to develop the efficiency and effectiveness of chaplaincy and thus maximize the benefits of pastoral care to prisoners. Implications of this exploratory study relate not only to prison chaplaincy but also to ecclesiastical organizations, correctional facilities, governments and the need of support for further research to be conducted.     

Abortion and Health Care Chaplaincy in Australia

This paper summarizes the results gained from quantitative and qualitative research involving 327 Australian health care chaplains with regard to their involvement in abortion issues within the health care context. The findings indicate that approximately 20% of surveyed chaplains had provided some form of pastoral intervention to patients and/or their families dealing with issues of abortion and that approximately 10% of chaplains had assisted clinical staff with issues concerning abortion. There was found to be no-statistically significant difference with regard to the number of catholic chaplains compared with protestant chaplains or staff chaplains compared with volunteer chaplains involved in abortion issues. Analysis using the WHO Pastoral Intervention codings highlighted a variety of issues encountered by chaplains and the non-judgmental pastoral care used by chaplains when assisting those dealing with abortion. Some implications of this study with respect to patient and clinical staff support are suggested. Dr. Lindsay Carey, M.App.Sc., Ph.D.: National Research Fellow, Australian Health & Welfare Chaplains Association & Faculty Associate, Palliative Care, School of Public Health, La Trobe University, Melbourne, Australia. Dr. Christopher Newell, AM, Ph.D.: Associate Professor, School of Medicine, University of Tasmania, Hobart, Australia.     

Confidentiality and Mental Health/Chaplaincy Collaboration

Confidentiality can both facilitate and inhibit working relationships of chaplains and mental health professionals addressing the needs of service members and veterans in the United States. Researchers conducted this study to examine opportunities for improving integration of care within the Department of Defense (DoD) and Department of Veterans Affairs (VA). Interviews were conducted with 198 chaplains and 201 mental health professionals in 33 DoD and VA facilities. Using a blended qualitative research approach, researchers identified several themes from the interviews, including recognition that integration can improve services; chaplaincy confidentiality can facilitate help seeking behavior; and mental health and chaplain confidentiality can inhibit information sharing and active participation on interdisciplinary teams. Cross-disciplinary training on confidentiality requirements and developing policies for sharing information across disciplines is recommended to address barriers to integrated service delivery.     

Organ Procurement and Health Care Chaplaincy in Australia

As part of an Australian national project, quantitative data via a survey were retrospectively obtained from 327 Australian health care chaplains (staff and volunteer chaplains) to initially identify chaplaincy participation in various bioethical issues—including organ procurement. Over a third of surveyed staff chaplains (38%) and almost a fifth of volunteer chaplains (19.2%) indicted that they had, in some way, been involved in organ procurement issues with patients and/or their families. Nearly one-fifth of staff chaplains (19%) and 12% of volunteer chaplains had also assisted clinical staff concerning various organ procurement issues. One hundred of the surveyed chaplains volunteered to an interview. Qualitative data were subsequently coded from 42 of the chaplains who had been involved in organ procurement requests. These data were thematically coded using the World Health Organization ‘Pastoral Intervention Codings’ (WHO-PICs). The qualitative data revealed that through a variety of pastoral interventions a number of chaplains (the majority being staff chaplains) were engaged in the critical and sensitive issues of organ procurement. It is argued that while such involvement can help to ensure a holistic and ethically appropriate practice, it is suggested that chaplains could be better utilized not only in the organ procurement process but also for the training of other chaplains and clinicians.     

Muslims in the United States: An Exploratory Study of Universal and Mental Health Values

The authors surveyed the universal and mental health values of 121 Muslims in the United States and their counseling preferences. The respondents were generally well educated and highly religious. They responded high in the universal values of benevolence and conformity; low in power, hedonism, and stimulation; and high in many humanistic mental health values. A comparison with typical counselor values showed both similarities and differences. A substantial minority indicated a willingness to go to a non-Muslim counselor but most would want a counselor with an understanding of Islam. Implications for counseling practice and future research are discussed.     

Affective geographies in pandemic times: An intersectional analysis of women's wellbeing in Aotearoa New Zealand

This article builds upon and extends a growing body of literature focused on how the pandemic has shifted human relations with space, place, and wellbeing. Working at the intersection of pandemic and feminist geographies, we focus on how the reconceptualizing of familiar spaces and places during the COVID-19 pandemic impacted women's embodied, affective, and subjective experiences of wellbeing. Drawing upon interviews with 38 women from diverse socio-cultural backgrounds living in Aotearoa New Zealand during the first two years of the COVID-19 pandemic, we detail the emergence of different spatial arrangements and affective relations with familiar spaces and places (i.e., domestic, nature, and digital spaces). We then explain how these emergent affective and spatial relations prompted new understandings of wellbeing. The article also highlights the multiplicities of women's subjective experiences of wellbeing as shaped by their varied socio-cultural positionings in relation to pandemic geographies.     

Standards for Health Care Chaplaincy in Europe: Questions from an Orthodox Perspective

The Standards' ecumenical implications are critically assessedin view of the risks which their cross-denominational or cross-faithcooperation implications on the one hand, and, on the otherhand, their secular commitments to mutual learning, non-proselytizing,professionalism, and efficiency assessment might carry for chaplains'properly spiritual orientation. The problem posed by the ambiguityof language is raised as a warning that concepts like humandignity have a profoundly different meaning in secular and Christiancontexts. Invoking such concepts can be seriously misleading.     

Australian Chaplaincy Support of Health Care Staff: Presence,Professional and Relational

Journal of Religion and Health - The aim of the research was to explore how health care staff experienced support from hospital chaplains. The context for the study was two acute care hospitals in...     

Shifting landscapes of counselling identities in Aotearoa New Zealand

ABSTRACT

The professional identity of counsellors and guidance practitioners in Aotearoa New Zealand is currently under review as a result of the passing of legislation regulating health professionals and the proposed introduction of national registration of counsellors. In this paper I explore this debate, and examine the professional identities claimed by counsellors, counselling psychologists and psychotherapists. The current discussion in this country is both informed by and provides an illuminating lens on professional identity issues in Australia, the UK and the US. An alternative construction of professional identities that are localised and dynamic, yet distinctly of Aotearoa New Zealand, is proposed.     

The Value of Exploratory Structural Equation Modeling in Identifying Factor Overlap in the Mental Health Continuum-Short Form (MHC-SF): A Study with a New Zealand Sample

This study is the first to investigate the factor structure of the Mental Health Continuum-Short Form (MHC-SF) in New Zealand. Towards this end, traditional Confirmatory Factor Analysis (CFA) and the new method of Exploratory Structural Equation Modeling (ESEM) were used. Both ESEM and CFA supported the tripartite model of mental well-being in comparison to the one- and two-factor models; however, ESEM provided better fit with the data. Moreover, interfactor correlations were considerably lower in ESEM than they were in CFA, indicating greater factor distinctiveness in ESEM. ESEM also revealed a number of important cross-loadings for items in the measurement model of the MHC-SF. The results supported full metric and full scalar invariance of the MHC-SF across gender. The attenuated correlations among well-being factors obtained by ESEM here provide an important insight about the ongoing controversy regarding the failure of empirical research to identify distinct eudaimonic and hedonic factors in well-being measures. An overreliance on CFA methods may have led the field to rely on inflated estimates of shared variance between eudaimonia and hedonia.     

Mental Health and Managed Care

In this essay I continue the conversation going on today on the crisis in delivering mental-health care within the realities of managed care. A guiding perspective is represented briefly in material from the writings of Edmund Pellegrino. He recommends the norm of patient-centered relationships to direct and govern managed care so cost can be controlled, but not by the sacrifice of quality of care. This emphasis must be balanced with a struggle for the greater social good and fair allocation of goods to all citizens. Definitions are offered along with a discussion of controversial issues and constructive suggestions to make possible a better future for the work of mental health in relation to managed care.     

Predictors of Health Care Use Among Individuals Seeking Therapy for Marital and Family Problems: An Exploratory Study

A number of studies have examined variables associated with health care use. However, no study is known to have considered health care use among people seeking services for marital and family problems. In this study, health care use of persons (N = 110) seeking these services was investigated to determine the strongest psychosocial correlates of health care use. The goal was to identify potential “targets” of clinical intervention that may be driving excessive health care use. “Informational support” and “somatization” were the strongest correlates for the complete sample, with the model explaining 24% of the variance in health care use. For “high users” of health care, “hostility” was the strongest correlate, accounting for more than 36% of the variance in health care use.     

Work and psychiatric illness in Aotearoa/New Zealand: implications for career practice

ABSTRACT

This paper aims to examine the influence of Māori culture upon psychiatric service provision in Aotearoa/New Zealand and the implications of this for career counselling of people with experience of mental illness in Aotearoa/New Zealand. The research explored the experiences of a group of women in Aotearoa/New Zealand who have been diagnosed with a psychiatric illness, with the aim of gaining some understanding about how they negotiate issues around diagnosis, recovery and resilience development and employment. The women interviewed for the study ranged in age from 17 to late 60s. They displayed academic ability ranging from literacy issues to postdoctoral experience. Their psychiatric illnesses ranged from single episodes to chronic lifetime conditions and from depression to psychotic bi-polar disorder. Their occupations ranged from unemployed status to an acting CEO. All but one of the women identified as Pākehā/tauiwi. One woman had Māori heritage but had been adopted at birth by Pākehā adoptive parents and had no knowledge of her Māori whakapapa [genealogy; descent lines; ancestry] until later in her adult life. The key idea that emerged was the importance of mentors in vocational settings, and the helpfulness of Māori-focused group and family wellness models for renegotiating vocational identity when suffering from a psychiatric illness. Implications for career practitioners are discussed.     

Moral Injury,Chaplaincy and Mental Health Provider Approaches to Treatment: A Scoping Review

Journal of Religion and Health - The aim of this research was to describe the evidence examining the approaches taken by mental health providers (MHPs) and chaplains to address symptoms related to...     

Ageism in Mental Health and Health Care: A Critical Review

Discussions of aging and mental health widely assume that ageism among mental health providers is an important factor limiting access to mental health services for older adults. Given the widespread citation of ageism as a problem, we critically review the history of the ageism construct, and evidence for its existence in both mental health and medical professionals. There is surprisingly little empirical evidence for age bias among mental health providers. Considerable evidence does suggest differential medical treatment for older adults in such diverse areas as physician–patient interaction, use of screening procedures, and treatment of varied medical problems, although it is unclear whether age bias accounts for these differences. We suggest that innovations in delivery of psychological services, such as collaborative medical/psychological care in primary care settings, may ultimately prove more useful in improving access to mental health services than efforts to combat ageism.