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.     

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.     

Military Chaplaincy in International Operations: A Comparison of Two Different Traditions

This article examines the role of military chaplains who accompany soldiers on international military and peace-keeping operations, such as those in Iraq, Afghanistan, Kosovo, and Bosnia Herzegovina. It compares and contrasts the two principal traditions of military chaplaincy in the international field—chaplains within the military structure (as in the UK) and parish-based chaplains who remain outside the military (as in Germany). The authors examine the potential conflict between the religious vocation of military chaplains and their role in military operations, which can be particularly contentious from an ethical viewpoint. Interviews with chaplains from both countries provide a unique insight into their experiences.     

Health Care Chaplains and their Role on Institutional Ethics Committees: An Australia Study

This paper presents the results of the largest Australian pastoral study concerning the perceptions of health care chaplains about their involvement on hospital research ethics committees (also known in some contexts as institutional ethics committees). Survey results from over 300 Australian health care chaplains indicated that nearly 90% of chaplains believed there was merit in chaplains serving on hospital research ethics committees, yet only a minority (22.7%) had ever participated on such committees. Data from in-depth interviews is also presented exploring the reasons for the lack of participation and the varying opinions regarding the role, appropriateness, and value of chaplains on ethics committees. Some implications of this study with respect to chaplaincy, hospital research ethics committees, health care institutions, ecclesiastical institutions, and government responsibilities are discussed.     

Chaplain–Physician Consultancy: When Chaplains and Doctors Meet in the Clinical Context

This paper summarizes the perspectives of 327 Australian health care chaplains concerning their interaction with physicians within the clinical context. In general terms the findings indicated that nearly 90% of chaplains believed that it was part of their professional role to consult with physicians regarding patient/family issues. Differences of involvement between volunteer and staff chaplains, Catholic and Protestant, male and female chaplains and the type of chaplaincy training are noted, as are the perspectives of chaplaincy informants regarding their role in relation to physicians. Some implications of this study with respect to chaplaincy utility and training are noted.     

Perspectives from the Edge: Chaplains in Greater Boston, 1945–2015

We follow Bender et al.’s (Religion on the Edge: De‐Centering and Recentering the Sociology of Religion) call to study religion “on the edge” by looking at the work of chaplains, religious professionals who work outside of congregations. Rather than studying chaplains within a single type of institution—the military, healthcare, or other sectors—we shift the unit of analysis to geography, asking where chaplains in Greater Boston worked between 1945 and the present. Based on coverage in the Boston Globe, we find that chaplains, mostly men, worked across Greater Boston between 1945 and 2015. The majority were Catholic with frequent minorities of Protestants and Jews, and—after 1995—a few Buddhists, Muslims, and Humanists. Most worked in higher education, healthcare, and prisons. While much of the chaplains’ work seems improvisational and varied, we identify services related to ceremonies, bearing witness, and working around death as common occurrences across the venues where chaplains worked. To the extent that these patterns are evident in other cities, they suggest that chaplains have regularly been a quiet part of the religious landscape, that they are a consistent part of the institutional field, and that their work has more commonalities across sectors than previous studies suggest.     

Chaplains' Engagement with Suicidality among Their Service Users: Findings from the VA/DoD Integrated Mental Health Strategy

Chaplains play an important role in supporting the mental health of current and former military personnel; in this study, the engagement of Department of Veterans Affairs (VA), Army, Navy, and Air Force chaplains with suicidality among their service users were examined. An online survey was used to collect data from 440 VA and 1,723 Department of Defense (DoD) chaplains as part of the VA/DoD Integrated Mental Health Strategy. Differences were noted for demographics, work setting characteristics, encountering suicidality, and self‐perceived preparation for dealing with suicidality. Compared to DoD chaplains, VA chaplains encounter more at‐risk service users, yet feel less prepared for dealing with suicidality.     

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.     

Factors that Influence Chaplains’ Suicide Intervention Behavior in the Army

We surveyed 868 Army chaplains and 410 chaplain assistants (CAs) about their role in identifying, caring for, and referring soldiers at risk of suicide to behavioral health care. We applied structural equation modeling to identify how behaviors and attitudes related to intervention behavior. In both samples, reluctance and stigma were related to intervention behaviors; efficacy was correlated with intervention behaviors only among chaplains. Training was associated with increased efficacy and lower levels of stigma among chaplains. Improved training may be warranted, but research needs to identify why chaplains and CAs are reluctant to refer soldiers in distress to behavioral health care.     

Revs and Psychos: Role,Impact and Interaction of Sport Chaplains and Sport Psychologists within English Premiership Soccer

Despite an increased focus on spirituality and athlete well-being in sport (Watson, 2011), there is limited research regarding those who provide support to the athlete in these areas. The aim of this study was to explore the practice of sport psychologists and sport chaplains within professional soccer, and identify potential for working partnerships. By interviewing three psychologists and four chaplains who are employed currently within English Premiership soccer, it was revealed that significant overlap in their roles existed. The psychologists and chaplains identified barriers that restricted support offered to players, which may be addressed by working cooperatively in the future.     

How are health care chaplains helpful to bereaved family members? Telephone survey results

After conducting telephone interviews with 130 next-of-kin whose loved one died, the authors report whether and how chaplains were helpful to these family members. Analysis of their responses indicated that chaplains were helpful in five ways. They provided comfort and support; they helped family members with details before, during, and after death; they acted as surrogate family members until other loved ones arrived; their availability provided a safety net even if contact was limited; and they functioned as a spiritual figure who provided the transition of the patient from earth to heaven. Family members rated the helpfulness of chaplains as midway between very good and excellent.     

What Do Chaplains Contribute to Large Academic Hospitals? The Perspectives of Pediatric Physicians and Chaplains

This article analyzes interviews with pediatric physicians (N = 30) and chaplains (N = 22) who work at the same large academic medical centers (N = 13). We ask how pediatric physicians understand and work with chaplains and how chaplains describe their own work. We find that physicians see chaplains as part of interdisciplinary medical teams where they perform rituals and support patients and families, especially around death. Chaplains agree but frame their contributions in terms of the perspectives related to wholeness, presence, and healing they bring. Chaplains have a broader sense of what they contribute to patient care than do physicians.     

Chaplaincy and Mental Health Care in Aotearoa New Zealand: An Exploratory Study

This paper summarizes an initial exploratory study undertaken to consider the ministry of New Zealand chaplaincy personnel working within the mental health care context. This qualitative research (a first among New Zealand mental health care chaplains) was not concerned with specific health care institutions per se, but solely about the perspectives of chaplains concerning their professional contribution and issues they experienced when trying to provide pastoral care to patients, families, and clinical staff involved in mental health care. Data from a single focus group indicated that chaplains were fulfilling various WHO-ICD-10AM pastoral interventions as a part of a multidisciplinary and holistic approach to mental health care; however, given a number of frustrations identified by participants, which 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 patients, families, and clinical staff. Some implications of this exploratory study relating to mental health care chaplaincy, ecclesiastical organizations, health care institutions, and government responsibilities and the need for further research are noted.     

Negotiating Religious Differences: The Strategies of Interfaith Chaplains in Healthcare

Chaplains in healthcare increasingly work in interfaith roles with patients and families from a range of religious and spiritual backgrounds. Some move with ease between their own religious backgrounds and those of the individuals with whom they work. Others encounter tensions as their status as a person of faith comes into conflict with their status as an interfaith chaplain. We explore the two main strategies—neutralizing and code‐switching—chaplains at one large academic medical center use when working with patients and families whose religious and spiritual backgrounds are different from their own. Through training in clinical pastoral education and experiences on the job, chaplains learn to neutralize (use a broad language of spirituality that emphasizes commonalities rather than differences) and to code‐switch (use the languages, rituals, and practices of the people with whom they work). To the extent that the strategies evident here are present among chaplains in a broader range of institutional settings, they suggest a kind of spiritual secularism or broad approach to meaning makings that may be facilitated by interfaith chaplains in a range of settings.     

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.     

The impact of the Family Communication Coordinator (FCC) Protocol on the role stress of hospital chaplains

The Family Communication Coordinator (FCC) Protocol was implemented to provide early family intervention and to facilitate effective communications during potential organ donation cases. Previous studies found the Protocol associated with improved donor outcome measures and with reduced role stress for ICU nurses caring for potential donors. The present study examines the impact of the Protocol on the perceived role stress of hospital chaplains serving as FCCs. All hospital chaplains serving as FCCs at an academic teaching hospital were surveyed. Their perceptions of job dimensions, role stress, job satisfaction, and commitment were measured; interviews and secondary data supplemented the surveys. The findings demonstrate that the FCC Protocol is associated with improved role stress, specifically role ambiguity and role conflict, among hospital chaplains serving as FCCs. Additionally, the findings suggest that satisfaction with the Protocol may be associated with experience with the Protocol.     

An analysis of referrals to chaplains in a community hospital in New York over a seven year period

The study analyzed the pattern of referrals to chaplains in a suburban hospital over a 7-year period. Nurses made more than half of all the referrals to chaplains, with nursing accounting for 81.74% of referrals from staff members other than pastoral care workers and volunteers. Social workers and physicians made 11.74% and 4.08% of referrals, respectively. The number of referrals from social workers (r=.86, p<.05), nurses (r=.68, p<.10) and other staff (r=.69, p<.10) increased across years, with the exception of physicians. Three quarters of referrals were requests for chaplains to visit patients and one quarter were requests to visit with family or friends. A significant difference was found in the percentage of referrals made for patients and family/friends by staff members (p<.05), with social workers making a higher percentage of referrals for relatives and friends (34.1%), compared to nurses (26.74%) and physicians (27.27%). The most common presenting problems for which patients were referred to chaplains were anxiety, depression, and pregnancy loss. The rate of referrals for patients over the entire study period was 39.04 per 1000 patient stays.     

Practical Matters and Ultimate Concerns, “Doing,” and “Being”: A Diary Study of the Chaplain's Role in the Care of the Seriously Ill in an Urban Acute Care Hospital

Systematic observational studies of the chaplain's role and function in the secular health‐care setting are few. With an episode‐based diary recorded on handheld digital tablets, palliative care chaplains at a large urban hospital with a diverse patient population recorded details of patient visits in near‐real time. Cluster analysis revealed groups of activities we called "doing" and "being," and conversation topics of "practical matters" and "ultimate concerns”; chaplains were most satisfied with visits that involved all of these. Chaplains offer patients and families a space to express significant concerns; however, visits with spiritual or religious activities or topics were relatively rare. Broad quality of life concerns are central to the evolving professional role of chaplains in the secular setting of the modern hospital.     

Hospital Chaplaincy As Agapeic Intervention

The notion of hospital chaplaincy raises significant concerns,because it provides for the possibility that the chaplain becomesa generic chaplain rather than a member of a particular faith.Despite these reservations, however, I think that Mennonitesshould serve as hospital chaplains. Instead of seeing themselvesas chaplains to all, though, Mennonites ought to see the servicethey provide as analogous to relief and development work. Thiswould make Mennonite chaplaincy a form of what Mennonite scholarC. Norman Krause calls "agapeic intervention," which would allowfor the ministry to the sick without requiring genericism.