Pastoral Care in Aged Care Settings: Role and Challenges

Journal of Religion and Health - This mixed methods study explored challenges faced by pastoral care workers. A development phase preceded an on-line survey completed by chaplains and pastoral...     

Conceptions of Care: Altruism,Feminism, and Mature Care

In “Conceptions of Care,” Tove Pettersen discusses and articulates select ways in which care can be comprehended. Several difficulties related to an altruistic understanding of care are examined before the author presents the case for a more favorable concept: mature care. Mature care is intended to take into account the interests of both parties to the caring relationship. This understanding of care facilitates the expression of the relational and reciprocal aspects of caring while emphasizing the equal worth of all involved. Also attended to is the embeddedness of care in wider cultural and political contexts.     

Pastoral Care: Myth and Reality

The increase in pastoral-care systems in secondary schools over the last fifteen years is examined. It is suggested that pastoral care is more effective in allaying the anxieties of teachers and their organisations than it is in meeting the social and personal needs of pupils. It is also suggested that pastoral-care systems assume responsibilities which are more properly those of the family, and that the best way schools can offset the effects of poor home environments is via good subject teaching and increased pupil involvement in schools.     

Designing Robots for Care: Care Centered Value-Sensitive Design

The prospective robots in healthcare intended to be included within the conclave of the nurse-patient relationship—what I refer to as care robots—require rigorous ethical reflection to ensure their design and introduction do not impede the promotion of values and the dignity of patients at such a vulnerable and sensitive time in their lives. The ethical evaluation of care robots requires insight into the values at stake in the healthcare tradition. What’s more, given the stage of their development and lack of standards provided by the International Organization for Standardization to guide their development, ethics ought to be included into the design process of such robots. The manner in which this may be accomplished, as presented here, uses the blueprint of the Value-sensitive design approach as a means for creating a framework tailored to care contexts. Using care values as the foundational values to be integrated into a technology and using the elements in care, from the care ethics perspective, as the normative criteria, the resulting approach may be referred to as care centered value-sensitive design. The framework proposed here allows for the ethical evaluation of care robots both retrospectively and prospectively. By evaluating care robots in this way, we may ultimately ask what kind of care we, as a society, want to provide in the future.     

Characteristics of Children in Foster Care,Family-Style Group Care,and Residential Care: A Scoping Review

When risky child and family circumstances cannot be resolved at home, (temporary) 24-h out-of-home placement of the child may be an alternative strategy. To identify specific placement risks and needs, care professionals must have information about the child and his or her family, care history, and social-cultural characteristics at admission to out-of-home care. However, to date information on case characteristics and particular their similarities and differences across the three main types of out-of-home settings (namely foster care, family-style group care, and residential care) is largely lacking. This review compiles and compares characteristics of school-aged children of average intelligence and their families at the time of each child’s admission to one of the three care modalities. A scoping review technique that provides a broad search strategy and ensures sufficient coverage of the available literature is used. Based on the 36 studies included, there is consensus that the majority of normally intelligent children in care demonstrate severe developmental and behavioral problems. However, the severeness as well as the kinds of defining characteristics present differ among the children in foster care, family-style group care, and residential care. The review also identifies several existing knowledge gaps regarding relevant risk factors. Future research is recommended to fill these gaps and determine the developmental pathway in relation to children’s risks and needs at admission. This will contribute to the development of an evidence-based risks and needs assessment tool that will enable care professionals to make informed referrals to a specific type of out-of-home care when such a placement is required.     

Rethinking Care Theory: The Practice of Caring and the Obligation to Care

Care theorists have made significant gains over the past twenty‐five years in establishing caring as a viable moral and political concept. Nonetheless, the concept of caring remains underdeveloped as a basis for a moral and political philosophy, and there is no fully developed account of our moral obligation to care. This article advances thinking about caring by developing a definition of caring and a theory of obligation to care sufficient to ground a general moral and political philosophy.     

Life Care Ministry:

As St. John's Lutheran Church in Stamford, Connecticut recognized that senior citizens comprised about 18% of its membership, the congregation decided to hire a full-time staff person to develop and direct a ministry program with the elderly. The program offers group meetings, information and referral, direct services, and visitation. It provides spiritual, educational, and fellowship opportunities, and supports the elderly's independence. Instruction about aging, and involvement of younger members in this ministry, has drawn the congregation together with a sense of understanding, community, and mutual responsibility. St. John's approach demonstrates the important role churches can have in the support network of the elderly.     

Spiritual Care: Define and Redefine Self

Spiritual care is deep rooted in the traditional ancient system of medicine. However, due to lack of high grade evidences, practitioners of modern system of medicine are hesitant to inculcate spirituality in their clinical practice. This paper is an attempt to basic understanding of spiritual care therapy, current evidences for it and the challenges for incorporation in the allopathic system of medicine.

     

医院药学服务与人文关怀

医院药学服务是医院医疗服务中的重要组成部分,药师在医院人文服务中起着重要作用.本文阐述了人文关怀在医院药学服务中的实施,指出药师在日常工作中的每个环节都要为患者提供充满人文关怀的服务,并指出了现在医院药学服务的人文关怀中存在的困难及解决办法.     

医院药学服务与人文关怀

医院药学服务是医院医疗服务中的重要组成部分,药师在医院人文服务中起着重要作用。本文阐述了人文关怀在医院药学服务中的实施,指出药师在日常工作中的每个环节都要为患者提供充满人文关怀的服务,并指出了现在医院药学服务的人文关怀中存在的困难及解决办法。     

Moral Injury: Contextualized Care

Amidst the return of military personnel from post-9/11 conflicts, a construct describing the readjustment challenges of some has received increasing attention: moral injury. This term has been variably defined with mental health professionals more recently conceiving of it as a transgression of moral beliefs and expectations that are witnessed, perpetrated, or allowed by the individual. To the extent that morality is a system of conceptualizing right and wrong, individuals’ moral systems are in large measure developmentally and socially derived and interpreted. Thus, in seeking to provide care and aid in reintegration for combat veterans, it is necessary to consider communities that have contributed to an individual’s formation and that might have participated in the interpretation of his/her suffering. This can take many forms, but given that morality is often complexly intertwined with issues of religion, faith, and spirituality for many individuals, and recognizing that much of the current focus on moral injury is emanating out of healthcare contexts, we devote particular attention to how chaplains might be more intentionally engaged in healthcare systems such as the Veterans Health Administration to provide non-judgmental, person-centered, culturally-relevant care rooted in communities of practice to veterans with moral injury.     

Treatment Foster Care in a System of Care: Sequences and Correlates of Residential Placements

We examined Treatment Foster Care (TFC) in residential trajectories for youth with psychiatric disorders and aggressive behavior. We analyzed residential placements of a statewide sample of youth during the 12 months preceding and following admission to TFC. Prior to TFC, the majority of youth were residing in more restrictive settings (group homes or residential treatment). Two-thirds of youth remained in TFC throughout the follow-up year. Of those who left, nearly half returned home, and slightly fewer were discharged to group homes. By the end of the 12-month follow-up period, rates of group home use were similar to those seen in the pre-TFC period. Movement out of TFC during the year was associated with being older at placement and with increased problem behavior (particularly externalizing behaviors). TFC serves as a step-down placement for a substantial number of youth. However, this is not the only way it is used, and models based on short-term transitioning or reunification with families may not be widely implemented or relevant in practice. Additional research is needed to understand current functions of TFC in residential trajectories and to maximize its utility in systems of care.     

Building Bridges with Accessible Care: Disability Studies,Feminist Care Scholarship,and Beyond

This article uses elements of autoethnography to theorize an in/formal support relationship between a friend with a physical disability, who uses attendant services, and me. Through thinking about our particular “frien‐tendant” relationship, I find the common scholarly orientations toward “care” are inadequate. Starting from the conversations between feminist and disability perspectives on care, I build on previous work to further develop the theoretical framework of accessible care. Accessible care takes a critical, engaged approach that moves beyond understanding “accessibility” as merely concrete solutions to create more inclusive forms of care. Care, in this context, is positioned as an unstable tension among competing definitions, including that it is a complex form of oppression. Accessible care draws on feminist disability perspectives and the feminist political ethic of care to build bridges in four areas: from daily experiences of disability and support to theoretical discussions; across feminist care research and disability perspectives; across divisions and anxieties within disability communities; and from the local to transnational applications. These bridges do not aim to resolve debates but allow us to travel back and forth between differing perspectives and demonstrate the tenuous possibility of accessible practices and concepts of care.     

文化背景与医疗行为:一个少数民族社区中的新型农村合作医疗

现有对民族社区新型农作合作医疗（以下简称新农合）的研究相对较少,同时在研究中忽略了在其独特民族文化背景下对于疾病与医疗的不同认知,这一认知影响了人们的医疗观念和医疗行为,也直接影响了人们对新农合的态度和行为。医学人类学关注文化与疾病、医疗的关系,以云南省福贡县赤恒底傈僳族社区新农合的田野调查为例,应用医学人类学的视角和社区研究方法对其进行研究,以期获得新的认识和理解。     

Care Ethics and Confucianism: Caring through Li

The role of li, or ritual, in Confucianism is a perceived impediment to interpreting Confucianism to share a similar ethical framework with care ethics because care ethics is a form of moral particularism. I argue that this perception is false. The form of moral particularism promoted by care ethicists does not entail the abandonment of social conventions such as li. On the contrary, providing good care often requires employing systems of readily recognizable norms in order to ensure that care is successfully communicated and completed through one's care‐giving practices. I argue that li performs this communicative function well and that the early Confucians recommend breaching li precisely when its efficacy in performing this function is compromised.     

Care for the Caregiver: Clues for the Pastoral Care of Clergywomen

In this article, we report the results of a qualitative study on the special challenges faced by clergywomen: the impact of gender, work demands, and personal and professional stressors, and the positive and negative coping strategies these clergywomen employed. We include a discussion of the pastoral care issues that emerged from the study and make recommendations for ways pastoral counselors may care for their own.     

A Level of Care Instrument for Children's Systems of Care: Construction, Reliability and Validity

The Child and Adolescent Level of Care System/Child and Adolescent Service Intensity Instrument (CALOCUS/ CASII) is designed to help determine the intensity of services needed for a child served in a mental health system of care. The instrument contains eight dimensions that are rated following a comprehensive clinical evaluation. The dimensions are risk of harm, functionality, co-morbidity (psychiatric, substance abuse, development disability and medical), environmental stressors, environmental supports, the child's resiliency, and the child and family's willingness to engage in treatment. An algorithm connects the ratings to a level of care recommendation. The instrument specifies six levels of care defined flexibly enough to consider whatever services are available. The results of psychometric testing using raters with a broad range of clinical experience and training from four different systems of care around the country are presented. The testing demonstrates excellent reliability when rating vignettes. Using children and adolescents in live system of care clinical settings, the CALOCUS/CASII demonstrates reasonable validity when compared with the Child Global Assessment Scale, and the Child and Adolescent Functional Assessment Scale.     

Pediatric Health-Related Quality-of-Life Measurement Technology: Intersections between Science, Managed Care, and Clinical Care

The demand for health care outcomes assessment is increasing, driven by the proliferation of managed care as a form of health care financing. Providers, consumers, and payers can use health care outcomes to improve the efficiency and quality of care, spur performance improvement, and demonstrate accountability. This review introduces health outcomes and focuses on one particular outcome—pediatric health-related quality of life (HRQOL), exemplified by the PedsQL, a brief, practical, reliable, valid, and responsive measure of pediatric HRQOL. HRQOL measurement has the potential, in pediatric clinical practice, to improve assessment, clinical management, and treatment evaluation if practical, conceptual, and empirical challenges are addressed. These issues are discussed and directions for future research are described that would demonstrate the value of HRQOL measurement in pediatric clinical settings.