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Zusammenfassung Spiritualität und religiöses Coping bei lebensbedrohlichen Krankheiten finden zunehmendes wissenschaftliches und praktisches Interesse im Sinne des Spiritual Care. Widersprüchlich sind allerdings die Aussagen über die Effekte dieser Bewältigungsform. Am Modell der HIV-Infektion als einer lebensbedrohlichen Krankheit in der Zeit vor Einführung der antiretroviralen Kombinationstherapie wurden die Häufigkeit und der Erfolg des religiösen Copings untersucht. 105 HIV-infizierte Männer und Frauen (55 Homosexuelle, 30 Hämophile und 20 Drogenkonsumenten) wurden in einem sozialpsychologisch-tiefenpsychologischen Interview über ihre Krankheitsbewältigung befragt. Die Auswertung hinsichtlich des religiösen Copings neben anderen Bewältigungsmechanismen erfolgte im Fremdrating mittels der Berner Bewältigungsformen nach Heim et al. (1990). Das Bewältigungsergebnis wurde mittels des Beeinträchtigungs-Schwere-Scores nach Schepank (1995) bestimmt. 25 % der Probanden, darunter fast nur Homosexuelle, hatten ein intensives und der Rest überwiegend kein religiöses Coping. Religiöses Coping führte zu keinem besseren Ergebnis als andere Mechanismen und wurde nicht vom Krankheitsstadium beeinflusst. Religiöses Coping war eng verknüpft mit einem internalen locus of control. Kein Zusammenhang fand sich mit Alter, Religionszugehörigkeit, Sozialschicht und Schuldphantasien. Religiöses Coping scheint eine relativ unabhängige stabile Verhaltensdisposition zu sein, die mit dem Gefühl der Eigenverantwortlichkeit verknüpft ist. Religiöse bzw. spirituelle Bedürfnisse sollten, falls vorhanden, bei der psychosozialen Betreuung der Patienten unterstützend berücksichtigt werden.

Background This study presents a concept for training general practitioners (GPs) in taking a spiritual history. In the same workshop, medical assistants (MAs) were trained in counselling elderly, chronically ill patients on social activities and home remedies. After the training, GPs and MAs will apply the acquired skills in their practices within the scope of the HoPES3 intervention study, which aims at raising patients’ self-efficacy. Methods Sixteen GPs and 18 MAs were trained in a 5-hour workshop and completed an evaluation questionnaire. Results All participants reported great satisfaction. In particular, 85% of GPs (n=11) affirmed increased capacity to address patients’ spiritual needs. About 88% (n=15) of MAs were satisfied with the training, yet expressed difficulties in integrating theoretical knowledge into daily professional routine. Discussion While the evaluation of the workshop is promising, the results of the randomized-controlled trial evaluating the effectiveness of the complete HoPES3 intervention have to be awaited. Conclusion To our knowledge, this is the first interdisciplinary, holistic care training in primary care in Germany. It fosters GPs’ and MAs’ competency in providing a proactive support in spirituality, social activities, and home remedies to their patients. If the concept proves to be effective, it could be integrated into existing care models and curriculums and provide clear guidance on how to consider elderly patients’ spiritual needs and strengthen their self-efficacy in primary care settings., Video abstract Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/hcz-CKYOk8s

Addressing spiritual concerns in psychotherapy might be challenging in secular societies. An additional obstacle may be a possible religiosity gap between psychotherapists and their patients. To ex...

Zusammenfassung Fragestellung Viele medizinische Fakultäten laden zu Erinnerungs- und Dankfeiern im Anschluss an den Kursus der Makroskopischen Anatomie ein. Im Hinblick auf eine bio-psycho-sozio-spirituell orientierte Aus-, Fort- und Weiterbildung untersucht die vorliegende Studie implizite Gefühle und Gedanken von Medizinstudierenden während der Feier, die Leib-/Körper-Differenzierung und die spirituellen Aspekte des medizinischen Unterrichtes. Methode Wir untersuchten 1653 kurze Texte, mit denen sich Studierende an die Körperspender wandten. Davon enthielten 140 auffällige Latenzen. Im Rahmen eines interdisziplinären Workshops identifizierten wir sechs Fälle, die wir mit zwei Verfahren der objektiven Hermeneutik bearbeiteten (Sequenzanalyse und Tiefenhermeneutik). Ergebnisse Während fortschreitender Entpersönlichung des im Verlauf des Präparierkurses fragmentierten Leichnams entsteht in den Studierenden die Repräsentanz einer Person „hinter“ dem anatomischen Objekt. Beim Abfassen des kurzen Textes an den Spender stellt die Bewältigung der Erfahrung von Vergänglichkeit für Studierenden eine persönliche spirituelle Herausforderung dar. Diskussion Die Berücksichtigung unbewusster Gefühle und Gedanken im Anschluss an den Präparierkurs kann Lehrende im Medizinstudium inspirieren.

Zusammenfassung Hintergrund: Forschung zeigt, dass der Einsatz von Spiritual Care nicht nur durch Zeit- und Ressourcenknappheit erschwert wird, sondern auch durch einen Mangel an Aus- und Weiterbildung sowie durch das bei Gesundheitsfachpersonen vorherrschende Gefühl von Inkompetenz in diesem Bereich. Im deutschen Sprachraum existiert wenig Forschung zu Kurs- oder Trainingsangeboten in Spiritual Care und deren Auswirkung auf die Kompetenzwahrnehmung von zukünftig im Gesundheitswesen Tätigen. Methode: 12 leitfadengestützte Interviews mit bayerischen Studierenden verschiedener Gesundheitsfächer, die an einem virtuellen Spiritual Care-Seminar teilgenommen haben, wurden mit qualitativer Inhaltsanalyse ausgewertet. Ergebnisse: Mithilfe des Seminars konnten verschiedene Arten der Veränderung angestoßen werden: (1) Öffnung: Vom Engen zur Weitung, (2) Präzisierung: Von Abstraktem zu Konkretem‚ (3) Fokussierung: Von Indifferentem zur Bewusstheit‚ (4) Ausweitung: Vom Exemplarischen zur Gesamtheit, (5) Professionalisierung: Von Privatem zu Beruflichem, (6) Persönlichkeitsentwicklung: Vom Zaghaften zur Kompetenz. Zudem brachte das Material die Kategorie (7) Fortbestand: Unverändertes und Leerstellen hervor. Diskussion: Die Ergebnisse weisen darauf hin, dass ein freiwilliges Online Spiritual Care-Seminar einen Transformationsprozess bei den teilnehmenden Studierenden auslösen konnte. Sie öffnen den Raum, die zugrundeliegenden Mechanismen weiter zu erforschen. Dies soll Lehrende ermutigen, Spiritual Care ins Studium zu integrieren, und dadurch sowohl das Kompetenzgefühl für als auch die Anwendungswahrscheinlichkeit von Spiritual Care in der Zukunft erhöhen.

Zusammenfassung Hintergrund Ebenso wie die World Psychiatric Association (WPA) und andere nationale psychiatrische Fachgesellschaften hat auch die Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN) ein Positionspapier zu Religiosität und Spiritualität (R/Sp) in Psychiatrie und Psychotherapie veröffentlicht, in dem sie Patientenzentrierung und spirituelle Kompetenz (SpK) der psychiatrischen Berufe fordert. Es ist bekannt, dass Kompetenzmangel das wichtigste Hindernis für die Implementierung von Spiritual Care (SpC) in die klinische Praxis darstellt. Fragestellung Ziel der vorliegenden Studie ist die praxisnahe Untersuchung der SpK in Psychiatrie und Psychotherapie. Wie schätzen psychiatrisch Tätige die SpK ihrer eigenen Berufsgruppe ein und welche Variablen beeinflussen dieses Urteil? Material und Methoden Insgesamt 391 psychiatrische Pflegekräfte, 75 Psychiater, 119 Therapeuten verschiedener Professionen und 62 andere (n = 647) aus Krankenhäusern in Deutschland und Österreich füllten den SpC Competency Questionnaire (SCCQ) aus. Ergebnisse Pflegekräfte, ältere und spirituell erfahrenere Personen schätzen die SpK der eigenen Berufsgruppe vergleichsweise höher ein und meinen seltener, diesbezüglich nicht zuständig zu sein. Pflegende nennen häufiger als andere Berufsgruppen das Fehlen geeigneter Räumlichkeiten als Hindernis für die Implementierung von SpC. Höhere Einschätzung der SpK der eigenen Berufsgruppe geht mit höheren Werten in den SCCQ-Faktoren „Selbsterfahrung und proaktive Öffnung“, „Team-Spirit“, „Wahrnehmungs‑/Dokumentationskompetenz“ einher. Diskussion Die Zuständigkeit der Gesundheitsberufe für SpC in Psychiatrie und Psychotherapie wird unter den deutschsprachigen psychiatrischen Berufsgruppen noch kontrovers diskutiert. Dies hängt mit mangelnder Kompetenz in diesem Feld zusammen.

Zusammenfassung Der Verlauf der religiösen Bewältigung bei einer lebensbedrohlichen Krankheit ist noch weitgehend unbekannt. Religiöse Phantasien bestimmen den Inhalt dieser Bewältigung. Modellhaft wird dies bei der HIV-Infektion vor Einführung der antiretroviralen Kombinationstherapie untersucht. 105 HIV-infizierte Männer und Frauen (55 Homosexuelle, 30 Hämophile und 20 Drogenkonsumenten) wurden in einem sozialpsychologisch-tiefenpsychologischen Interview über ihre Krankheitsbewältigung befragt. Von dieser Gruppe wurden 65 Teilnehmende nach durchschnittlich 21 Monaten einer zweiten Befragung unterzogen, um den Verlauf des religösen Copings zu erfassen. Das religiöse Coping wurde im Fremdrating mittels der Berner Bewältigungsformen nach Heim et al. (1985) und die religiösen Inhalte wurden inhaltsanalytisch bestimmt. Religiöse Bewältigung fand fast nur bei Homosexuellen statt. Im Verlauf nahm sie hochsignifikant an Intensität ab, und zwar unabhängig von der Verschlechterung der Krankheit. Ein Drittel schöpfte Kraft und Hilfe aus den religiösen Vorstellungen, ein Fünftel sah hier die Möglickeit einer aktiven Einflussnahme oder ordnete sich dem Willen Gottes unter. Bei den Gottesbildern überwogen die des strafenden oder verzeihenden Gottes, wobei die schuldhaft erlebte Homosexualität eine wichtige Rolle spielte. Die religiöse Bewältigung spielt vor allem zu Beginn einer lebensbedrohlichen Krankheit eine Rolle. Dabei geht es um das Verständnis der Krankheit in einem spirituellen Kontext. Die religiöse Verarbeitung von Schuldgefühlen verdient eine besondere Beachtung bei der psychosozialen Betreuung der Patienten.

The celibacy of Roman Catholic priests, in contrast to a single lifestyle, implies an existential choice for spiritual reasons as a conscious motivation. Nevertheless, several of them struggle with celibacy life style and some experience phases of spiritual dryness. So far it is unclear which role priestly celibacy may play in this context. We therefore intended to investigate whether and how celibacy on the one hand and supportive relations to other persons and feelings of loneliness on the other hand are connected to the experience of spiritual dryness among priests. As part of the German Pastoral Ministry Study, we analyzed data sets of 2531 priests. The results at first hand confirmed a correlation of spiritual dryness with a low commitment to celibacy and loneliness. Regression analyses revealed problems with sexuality and loneliness as an inability to be alone are relevant indicators of spiritual dryness. Our results point to two important concomitant mental conditions in a considerable number of cases: to continuous psychosexual problems and immaturities on one hand and to a basic incapacity to be alone, pointing to a serious structural deficit in the psychic life of some of our participants. Our study finally is a call to address these problems adequately, first of all for the mental health and spiritual truth of these persons, secondly also in the interest of all of those who priests are called to minister.

Zusammenfassung Hintergrund: In diesem Beitrag wird erstmals im deutschen Sprachraum ein Fragebogen zur Erfassung von Spiritual Care-Kompetenzen (SCCQ) validiert. Fragestellung: Welche Reliabilität und welche faktorielle Struktur hat der SCCQ? Methode: Querschnittserhebung (N=717, 74 % Frauen, 65 % katholisch). Statistische Methoden: Interne Konsistenz (Cronbachs α), explorative Faktorenanalyse (EFA), Strukturgleichungsmodellierung (SEM). Ergebnisse: Die EFA erbringt eine 7-faktorielle Struktur des SCCQ mit 26 Items: (1) Wahrnehmungs-Kompetenz; 2) Team-Spirit; 3) Dokumentations-Kompetenz; 4) Selbsterfahrung und proaktive Öffnung; 5) Wissen über andere Religionen; 6) Gesprächsführungs-Kompetenz; 7) proaktive Empowerment-Kompetenz. Cronbachs α der Skalen reicht von .73 bis .86. Die SEM bestätigt das Modell (cfi = 0.96, tli = 0.95, rmsea = 0.04, srmr = 0.05). Die „Gesprächsführungs-Kompetenz“ wird als am stärksten ausgeprägt eingeschätzt, die „Dokumentations-Kompetenz“ am geringsten. Keine wesentlichen Geschlechts-assoziierten, jedoch Alters-assoziierte Unterschiede. Schlussfolgerung: Der SCCQ eignet sich zur Erfassung von strukturellen und individuellen Förderungsbedarfen und zur Evaluierung von Trainingsmaßnahmen.

Background In order to facilitate better international and cross-cultural comparisons of health professionals (HPs) attitudes towards Religiosity and/or Spirituality (R/S) using individual participant data meta-analysis we updated the NERSH Data Pool. Methods We performed both a network search, a citation search and systematic literature searches to find new surveys. Results We found six new surveys (N=1,068), and the complete data pool ended up comprising 7,323 observations, including 4,070 females and 3,253 males. Most physicians (83%, N=3,700) believed that R/S had “some” influence on their patients’ health (CI95%) (81.8%–84.2%). Similarly, nurses (94%, N=1,020) shared such a belief (92.5%–95.5%). Across all samples 649 (16%; 14.9%–17.1%) physicians reported to have undergone formal R/S-training, compared with nurses where this was 264 (23%; 20.6%–25.4%). Conclusions Preliminary analysis indicates that HPs believe R/S to be important for patient health but lack formal R/S-training. Findings are discussed. We find the data pool suitable as a base for future cross-cultural comparisons using individual participant data meta-analysis.

The amount of research concerned with the values of health professionals (HPs) is steadily growing. Around the world HPs face similar challenges when patients express their existential and spiritual views. How HPs engage these views, and the degree of embedment into consultations, differ across cultures. Today, more than ever before, researchers in this field need to share experiences and build new knowledge upon local findings. To meet this demand, we founded the international collaboration "Network for Research on Spirituality and Health" ( https://NERSH.org ). One of the central projects of our network has been to build a large international data pool of health professionals' attitudes toward religiosity and spirituality. Today the data pool hosts answers from more than 6,000 health professionals from 17 separate surveys derived from 12 countries. Data were gathered by either the questionnaire "Religion and Spirituality in Medicine, Perspectives of Physicians" (RSMPP) or its successor 'NERSH Questionnaire'. In this article we describe the methodology behind the construction of the data pool. We also present an overview of five available scales related to HP religiosity and spirituality, including a description of scale reliability and dimensionality.

Existential or spiritual concerns are especially important for older people and those faced with their fragility and mortality. In most cases, the elderly have to deal with their worries and needs alone, as several perceive low interest in their concerns. This chapter describes which spiritual needs were of relevance for the elderly living in retirement homes, assisted living homes or nursing homes, and what may trigger these. Findings from studies among the elderly from Germany, Poland and Italy are discussed. There were similarities in specific unmet spiritual needs, and significant differences that refer particularly to Religious needs and Existential needs. The underlying causes are probably multifactorial and involve cultural and religious differences, on the one hand, and negative mood states, feelings of loneliness and perceived daily life affections (and thus low self-care abilities and independence), on the other hands. The loss of connectedness and involvement were identified as crucial, and thus support concepts could start with these topics. These should be suited to facilitating the elderly’s social participation and inclusion, on the one hand, and their independence and generative giving abilities, on the other hand, which would help to maintain feelings of meaningfulness and psychosocial and spiritual well-being.

Journal of religion and healthh : JRHEAT 60(5), 3621-3639 (2021). doi:10.1007/s10943-021-01402-7 special issue: "Special Section: Moral Injury", Published by Springer Science + Business Media B.V., New York, NY [u.a.]

In emergency rooms, the efforts of the hospital staff are necessarily patient-centered, while the concerns of relatives who accompany the patients are not in the primary focus. Consequently, relatives may wait for the patients and their needs to be addressed, or they may accompany the patients waiting, while their own fear and worries and their own needs go unnoticed. To assess how relatives rate their own spiritual needs and whether their needs differ from the patients´ needs, a cross-sectional survey was initiated enrolling 97 relatives from patients at a hospital´s emergency room. Surprisingly, the spiritual needs of relatives are not significantly different from patients´ needs. One explanation could be that both are in a similar phase of early insecurity about the implications of patients´ symptoms and illness. During the later course of being ill, relatives´ needs could change, depending on the implications of disease. However, the spiritual needs investigated herein are not disease-specific and may be experienced by all persons suffering from significant stressors, either due to disease, insecurity, hopelessness, etc.

Background: The purpose of this study was to contribute to the analysis of older people’s Meaning in Life and the implications of dwelling in residential and nursing homes. The transition from one’...

Research to date has shown that health professionals often practice according to personal values, including values based on faith, and that these values impact medicine in multiple ways. While some influence of personal values are inevitable, awareness of values is important so as to sustain beneficial practice without conflicting with the values of the patient. Detecting when own personal values, whether based on a theistic or atheistic worldview, are at work, is a daily challenge in clinical practice. Simultaneously ethical guidelines of tone-setting medical associations like American Medical Association, the British General Medical Council and Australian Medical Association have been updated to encompass physicians' right to practice medicine in accord with deeply held beliefs. Framed by this context, we discuss the concept of value-neutrality and value-based medical practice of physicians from both a cultural and ethical perspective, and reach the conclusion that the concept of a completely value-neutral physician, free from influence of personal values and filtering out value-laden information when talking to patients, is simply an unrealistic ideal in light of existing evidence. Still we have no reason to suspect that personal values, whether religious, spiritual, atheistic or agnostic, should hinder physicians from delivering professional and patient-centered care.

Zusammenfassung Religiöse/spirituelle Begleitung ist Aufgabe des multiprofessionellen Palliativteams. Seelsorgende mit kirchlichem Auftrag gehören in der Regel zu stationären Palliativteams. Die Mitarbeit der Seelsorge im ambulanten Bereich ist hingegen eher sporadisch und zufällig. In der vorgestellten Studie werden bestehende Formen der Mitarbeit kirchlicher Seelsorge in Teams der spezialisierten ambulanten Palliativversorgung (SAPV) im Bundesland Bayern untersucht. Es wurden 34 semistrukturierte Interviews mit Mitgliedern von 12 SAPV Teams (jeweils 6 mit/ohne Seelsorger/-in im Team) in Bayern geführt. Interviewt wurden 12 Ärzte bzw. Ärztinnen, 12 Pflegende, 4 Sozialarbeiter/-innen und 6 kirchliche Seelsorgende. Es zeigte sich, dass Spiritualität im Kontext der SAPV-Versorgung eine relevante Größe darstellt. Die Bereitschaft zu Spiritual Care ist bei Teammitgliedern unterschiedlich ausgeprägt, wobei sich der persönliche Bezug zu spirituellen Fragen förderlich auswirkt. Die Mitarbeit von Seelsorgenden im Team fördert die spirituelle Kompetenz der Teammitglieder und stellt eine Entlastung für das Team dar. Spiritual Care bildet eine Schnittstelle zwischen der „profanen“ naturwissenschaftlich und ökonomisch orientierten Logik des Gesundheitswesens und der religiös geprägten kirchlich verantworteten Seelsorge. Mit der daraus resultierenden Spannung gilt es im Blick auf das gemeinsame Ziel der Versorgung von Patienten und Zugehörigen konstruktiv umzugehen.

Organ donation and transplantation (ODT) is a complex multi-professional clinical procedure. Healthcare professionals’ attitudes and concerns towards the procedure influence the entire process. A 3-hour interview with ODT staff (13 participants) was performed in order to explore ODT professionals’ spiritual attitudes and concerns. The interview was recorded and transcribed verbatim. All (sub)themes were directly derived from the data. The discussants expressed the following issues: (1) ethical considerations and barriers in ODT; (2) individual beliefs about death and afterlife; (3) dealings with patients, relatives and close ones; (4) lack of support for ODT staff; and (5) spiritual facilitators. The interview provided a list of themes that either explicitly or implicitly demonstrate spiritual attitudes and concerns which may influence procedures in ODT. The themes and subthemes formed the basis to design a questionnaire in order to initiate a more detailed investigation of a larger group of professionals.

Proactively addressing religious and spiritual (r/s) issues has a strong intervention effect on patients, which is generally more important than the detailed content of spiritual screenings and assessments. When asked about r/s needs or problems, patients may feel bothered, surprised, annoyed, or, conversely, satisfied, supported, acknowledged in their coping efforts. Consequently, documentation should first and foremost reflect the patient’s reaction towards the clinician’s r/s intervention and to what extent the patient wishes this interaction to be shared within the healthcare team. In psychiatry and psychotherapy, patients’ spirituality is less pathologized than in former times and more and more accepted as a universal dimension of human experience, transcending individual religions. In mental health and in other medical fields, r/s may be part of the problem or part of the solution (K. Pargament), or both. Consequently, spiritual charting should not only differentiate pathological/negative and resilient/positive coping but consists of the patient’s r/s healthcare preferences and goals as well as the role he or she attributes to the health professional.

Although much is known about the frequency of the spiritual activities of pastoral workers, less is known related to how important specific spiritual and existential practices are to pastoral workers personally or existentially. This part of the German Pastoral Ministry Study analyzed (1) which forms of spiritual activities were regarded as important, (2) how the perceived importance of religious practices related to frequency of engagement in spiritual practices, and (3) how these practices contributed to the life satisfaction of ordained priests and of non-ordained pastoral workers. Participants included 1826 Catholic pastoral workers, composed of 65% priests and 35% (non-ordained) pastoral assistants and parish expert workers. Prosocial-Humanistic practices scored highest in importance, followed by Gratitude/Awe, Existentialistic practices, and Religious practices; specific forms of Spiritual Mind-Body practices were not relevant. Differences in the frequency and ascribed importance of spiritual practices between ordained and non-ordained pastoral workers were identified, as well as a surprising lack of connection between religious practices and their proclaimed importance, particularly of Prosocial-Humanistic and Gratitude/Awe practices. These findings may stimulate further research into the underlying causes of these differences between priests and other pastoral workers and between the frequency and importance of spiritual practices in all groups, which in the researchers’ opinion indicate challenging inconsistencies with regard to the ideals of religious vocations.

Zusammenfassung Fragestellung: In der vorliegenden Studie wird untersucht, welche Ausmase von Stresserleben (gemessen mit Cohens „Perceived Stress Scale“) in Berufsgruppen der Seelsorgenden vorliegen und wie diese im Vergleich zu anderen Berufsgruppen einzuordnen sind. Daruber hinaus wird berichtet, welche Auspragung fur Variablen des Lebensstils mit psychosomatischer Relevanz in den genannten Berufsgruppen auftreten. Hierzu erfolgt eine Analyse des Body-Mass-Index und des Konsums von Alkohol und Nikotin sowie eine Zusammenfuhrung dieser Variablen mit genanntem Stressparameter. Methode: Fur den hier vorliegenden Teil der deutschen „Seelsorgestudie“ wurden 6388 pastorale Mitarbeiterinnen und Mitarbeiter in 22 der 27 deutschen Diozesen anhand einer quantitativen Querschnittsstudie befragt. Ergebnisse: Die berichteten Werte des Stresserlebens in den Berufsgruppen der Seelsorgenden sind insgesamt gering. Auffallend sind ein erhohter Anteil an Personen mit taglichem Alkoholkonsum wie auch haufig auftretendes U...

In this study, we examined a third variable effect on the relationship of personality traits, especially neuroticism and the salutogenetic concept sense of coherence. Specifically, we were interested in the moderating role of religious trust (RT) and transcendence perception operationalized as daily spiritual experiences (DSE) on the aforementioned relationship among religious individuals. We applied a cross-sectional study among a sample of 8594 pastoral workers using standardized questionnaires. Multiple regression and moderator analysis displayed the relationships between big five personality variables and sense of coherence. Neuroticism was identified as a negative predictor to sense of coherence, indicating impairment on this psychological resource. RT and DSE appear to function as moderators that buffer the negative effects of neuroticism on sense of coherence among religious persons. This is an interesting finding because people with expressions of neurotic personality tendencies often struggle to find helpful methods of coping and may find a helpful resource in the concepts studied here.

Research has shown that spiritual coping is essential for palliative care patients in enhancing quality of life and that attachment patterns affect the emotional well-being of the terminally ill. This is the first study evaluating how spiritual coping and attachment are associated in palliative care patients. Four different attachment patterns-secure, dismissive, preoccupied, and unresolved-were examined, as well as how they relate to three different spiritual coping strategies-search, trust, and reflection. In a cross-sectional, correlative design, 80 patients were recruited from German palliative care wards and hospices. Attachment patterns were determined using the Adult Attachment Projective System and spiritual coping strategies by SpREUK questionnaire, measuring spiritual and religious attitudes in dealing with illness. The results indicate that there is an association between attachment style and spiritual coping. Preoccupied patients had the lowest score in spiritual coping, with the strategy "reflection" being significantly lowest (t = 2.389, P = .019). Securely and dismissively attached patients presented equally high scores, raising the question of what mechanisms underlie spiritual coping. Furthermore, the unresolved group scored high in spiritual coping. Heightening awareness for ways in which attachment styles influence spiritual coping can contribute significantly to the quality of life in terminally ill patients, enabling health care professionals to tailor to individual needs in this vulnerable stage of life.

To identify and investigate coping mechanisms and other factors which may impact upon the psychosomatic symptoms of aging German Roman Catholic priests. A cross-sectional study was conducted among 499 aging German Roman Catholic priests with standardized questionnaires: Brief Symptom Inventory, Coping Inventory Stressful Situations, and Religious Coping Scale. Task-Oriented Coping exhibited a significant difference between the two groups. Multiple regression analyses indicated that psychosomatic symptoms could be best predicted by means of Task-Oriented Coping mechanisms, identification with priesthood, and by a low Negative Religious Coping. The success of adaptive coping processes for older clergy may depend on how they employ strategies, strengthen their spiritual dimensions, and manage important psychosocial aspects of aging. In our sample, Depression and Somatization are explained best by Emotion-Oriented Coping. It is desirable for aging priests to be aware of protective factors like Role Identification, Task-Oriented Coping, and low Negative Religious Coping, which may be helpful in improving their psychological well-being.

ZusammenfassungDiese Studie behandelt praktische Probleme der spirituellen Anamnese im klinischen Umfeld. Nach einer 180-minütigen Schulung wurden die Teilnehmer eingeladen, spirituelle Anamnesen zu erheben und mit Hilfe von zwei zu diesem Zweck erstellten Fragebögen aus Sicht des Befragers und des Befragten zu bewerten. 56 spirituelle Anamnesen wurden durchgeführt. Die Einschätzung der beiden Gruppen zeigte eine statistisch hochsignifikante Übereinstimmung. Die Befrager äußerten (M = 3,4) eine größere Belastung als die Befragten (M = 1,9). Als Belastungsfaktoren wurden eigene Unsicherheit, ablehnende Haltung von Patienten und wenig unterstützende äußere Bedingungen identifiziert. Die Studie machte eine Kluft zwischen den eingeschätzten und tatsächlichen Fähigkeiten bei der Erhebung der spirituellen Anamnese deutlich.

We intended to study unaddressed psychosocial and spiritual needs among older people (of at least 65 years of age) living in nine residential/nursing homes in Bavaria in Southern Germany. We conducted an anonymous cross-sectional study with standardised questionnaires (i.e., Spiritual Needs Questionnaire, Brief Multidimensional Life Satisfaction Scale, Schedule for Meaning in Life Evaluation, etc.). Religious needs were predicted best by residents’ religious trust. Existential needs and inner peace needs correlated moderately with grief, and were predicted best by family/social support needs. All members of an interdisciplinary team should be trained in the specific competence of recognising older people's unmet spiritual needs. When these needs are recognised, caregivers and relatives have the chance to react.

Studying 7390 Roman Catholic pastoral workers (42 % priests, 13 % deacons, 20 % pastoral assistants, 25 % parish expert workers), we intended to clarify (1) which forms of religious activities were practiced and were thus of importance to them, (2) whether these activities were related to their experience of the transcendent in daily life, and (3) and how these measures were related to their psychosomatic health, stress perception and life satisfaction. We found almost equal levels of the experience of the transcendent in daily life (DSES) and in private prayer, but there were differences, particularly with respect to public prayer forms (e.g., the Eucharist, Liturgy of the Hours). The frequency of spiritual practices showed either no significant or only some marginal associations with psychosomatic health, while DSES showed weak to moderate associations. This perception of transcendence was predicted best by private prayer and life satisfaction.

Schicksal ist ein Gegenbegriff zu evidenzbasierter Medizin und Psychotherapie. Der Begriff taucht in Situationen auf, in denen unsere Erklarungs- und Kontrollmoglichkeiten an Grenzen stosen. Sowohl Patienten als auch Therapeuten geraten in einen Zustand der Verunsicherung, der sich auf die therapeutische Kompetenz und die Coping-Ressourcen lahmend auswirkt. Dieser negative Effekt des Schicksals verstarkt sich durch die fehlende Reflexion des zugrunde liegenden Konzepts in der Therapie und in der Selbstsorge der Therapeuten. Therapeutische Resilienz hat nicht die (Wieder-)Herstellung der Macht uber das Schicksal zum Ziel, sondern die Anerkennung der eigenen Verwundbarkeit, die mit jeglichem therapeutischen Handeln verbunden ist.

The Spiritual Needs Questionnaire (SpNQ) is an established measure of psychosocial, existential and spiritual needs. Its 4-factor structure has been primarily validated in persons with chronic diseases, but until now has not been done in elderly and stressed healthy populations. Therefore, we tested the factor structure of the SpNQ in: (1) persons with chronic diseases (n = 627); (2) persons with chronic disease plus elderly (n = 940); (3) healthy persons (i.e., adults and elderly) (n = 1468); and (4) chronically ill, elderly, and healthy persons together (n = 2095). The suggested structure was then validated using structured equation modelling (SEM). The 4-factor structure of the 20-item SpNQ (SpNQ-20) was confirmed, differentiating Religious Needs, Existential Needs, Inner Peace Needs, and Giving/Generativity Needs. The psychometric properties of the measure indicated (CFI = 0.96, TLI = 0.95, RMSEA = 0.04 and SRMR = 0.03), with good reliability indices (Cronbach’s alpha varying from 0.71 to 0.81). This latest version of the SpNQ provides researchers with a reliable and valid instrument that can now be used in comparative studies. Cultural and religious differences can be addressed using their different language versions, assuming the SpNQ’s structure is maintained.

This article elaborates on the hazards of spiritual history taking. It provides expert insights to consider before entering the field. In summer 2012, a group of spiritual care experts were invited to discuss the complexity of taking spiritual histories in a manner of hermeneutic circle. Thematic analysis was applied to define the emerging themes. The results demonstrate that taking a spiritual history is a complex and challenging task, requiring a number of personal qualities of the interviewer, such as ‘being present’, ‘not only hearing, but listening’, ‘understanding the message beyond the words uttered’, and ‘picking up the words to respond’. To ‘establish a link of sharing’, the interviewer is expected ‘to go beyond the ethical stance of neutrality’. The latter may cause several dilemmas, such as ‘fear of causing more problems’, ‘not daring to take it further’, and above all, ‘being ambivalent about one’s role’. Interviewer has to be careful in terms of the ‘patient’s vulnerability’. To avoid causing harm, it is essential to propose ‘a follow-up contract’ that allows responding to ‘patient’s yearning for genuine care’. These findings combined with available literature suggest that the quality of spiritual history taking will remain poor unless the health-care professionals revise the meaning of spirituality and the art of caring on individual level.

We investigated strategies of 763 Catholic priests (response rate 36%) to deal with phases of spiritual dryness, specifically their reactions toward these feelings, and which strategies were used. Most priests have found strategies to cope with feelings of spiritual dryness. Those who have managed to overcome these phases were stimulated “all the more to help others” and experienced “deeper spiritual clarity and depth.” Whatever strategy was chosen (we differentiated eight strategies in various combinations), there were no significant differences for priests’ self-efficacy expectation, transcendence perception or life satisfaction. Instead, we found significant differences for social support (F = 6.5; p

In order to properly distinguish between pastoral and psychotherapeutic counseling, one must clarify both the interpretive presuppositions underlying each of these professional practices and their respective societal contexts. As a common ground for both kinds of practice, at least insofar as they maintain a distance from the usual medical-scientific model of therapeutic intervention, an ontology of playing is recommended. More precisely, in order for counseling to truly come “into play,” any latent neo-pastoral power discourses must be critically exposed. Psychoanalytic counseling is characterized by rules of abstinence and neutrality as well as by attention to unconscious dynamics, especially those of transference and countertransference. Pastoral counseling, even when it takes place outside of the Ignatian exercises, can still orient itself toward the Ignatian model of spiritual accompaniment, thus requiring a discernment of spirits and a reference to transcendence. Both pastoral and psychotherapeutic counseling can profit from each other. Both must be evaluated in terms of whether, in the course of an authentic communication, they succeed in proposing what truly profits the person seeking advice. All of this applies with special urgency to bioethical decision making and conflict resolution: Persons seeking pastoral advice desire an authentic exposition of the values of the Gospel and their church community in order to reach a well-founded conclusion in conscience. Other persons (or even the same ones) seeking psychotherapeutic help in a bioethical conflict situation desire an empathetic mirroring back of the biographic background framing their decision and of possible psychic consequences that may ensue from their acting accordingly.

This therapy process study investigates the use of guided affective imagery for tumor patients. The therapeutic access to tumor patients is generally described as complex and challenging because of a disturbed emotion regulation and a defensive focus on reality. After autologous blood stem cell transplantation, 29 patients were treated with psychotherapy, including two daydreaming imagery sessions. Three text-analytical measures--Affective Dictionary Ulm, Regressive Imagery Dictionary, and Computerized Referential Activity for verbatim session transcripts--as well as the Quality of Life Questionnaire and the Karnofsky Performance Status were administered. Results show that guided affective imagery was able to enhance the psychotherapeutic process in tumor patients by activating the primary process, decreasing anxiety, and increasing referential activity. The positive emotional shift during imagery was achieved by the patients irrespective of their oncological severity status. Study limitations and future directions for research are discussed.

Das hier beschriebene medizinethische psychodramatische Rollenspiel ermoglichte es, brisante Szenarien der Aufklarung uber den Hirntod von Unfallopfern und die Moglichkeit einer Organ-Entnahme zur Transplantation nicht nur theoretisch durchzuspielen, sondern am eigenen Leib zu erleben (Rollenwechsel zwischen der jetzigen Studierenden- und der angestrebten Arztrolle; Rollenwechsel zwischen Arzt- und Angehorigenrolle). Diese Szenarien wurden durch weitere psychodramatische Techniken angereichert; die Studierenden beantworteten vor und nach der Unterrichtseinheit kurze Wissens- und Einstellungsfragebogen.

The aim of this research is to study the improvement of empathy in child-care professionals (i.e., teachers, psychologists, social workers) involved in the prevention of sexual abuse against children and youngsters. An E-Learning training pilot program was conducted with pre- and post-measures (T(1) = at the beginning and T(2) = after 6 months) using the program's standardized questionnaires of Situational Empathy and the Interpersonal Reactivity Index (IRI) as a Dispositional Empathy measure. A sample of 42 experienced professionals involved in activities with children and youngsters was obtained from the International Movement of Popular Education in Latin America called "Fe y Alegria." Significant progress was found in the scales of Situational Empathy and in some Coping subscales. The final outcomes seem to indicate that the prevention program elicits important changes in the cognitive sphere and that these changes are more intense when the implication level for the situation is greater. This research shows that empathy can be improved through professional experience and careful situational involvement.

We aimed to analyse stress perception, psychosomatic health and life satisfaction in pastoral professionals, paying particular attention to their individual and shared resources. Enrolling 8574 German pastoral professionals (48% priests, 22% parish expert workers, 18% pastoral assistants, 12% deacons), we found that pastoral professionals' stress perception is associated with psychosomatic health impairment. General self-efficacy was a beneficial resource to protect against stress perceptions, while perception of the transcendent had a further yet weakly positive influence for stress-related impairment of health. External stressors (i.e. team size, duration of work per week and size of pastoral unit) were only of marginal independent relevance.

To determine differences and interdependencies between patients and their support-givers prior to PBSCT.Patients and their principal support-givers completed the Illness- Specific Social Support Scale (ISSS), the Profile of Mood States, and the EORTC QLQ-C30.One hundred fifty-five of 200 eligible patients replied. They nominated spouse/partner (70.6%), friends, and children as principal support source. Patients receiving social support from spouses reported a better HRQoL than patients who nominated other persons as the principal source of social support. Patients perceived more positive (p.01) and more problematic (p.05) social interactions than support-givers. The support-givers nominated: children (25.8%), spouse/partner, and siblings. Analysis showed an additional effect of gender and support-giving role (female patients scored worst in overall QoL, male support- givers best).Psychotherapeutic interventions should not only address the patients' problems but also the support-givers' questions, needs, and psychosocial burdens.

Myths are generally considered as un or pre or anti-scientific. This naive naturalism ignores (1) myths as core elements of scientific paradigms; (2) myths as meaning-making constructions and illness narratives in patients' coping processes. Health professionals should know and respect cancer patients' private mythology in order to translate between scientific and subjective languages and to foster a growing adjustment with oncological illness.

In German, the concept of spirituality has two linguistic roots: (1) a French root (anchored in the Judeo-Christian tradition and still recently limited to specific Roman Catholic religious groups, e. g. Ignatian or Franciscan spiritualities); (2) an Anglo-Saxon root encompassing both institutionalized religiosity and subjective spiritual quests. Spiritual Care is a growing field of health care: All health professionals share a basic spiritual competency or should acquire it, especially for being able to take a patient's spiritual history.

Background: We wondered whether “spiritual dryness” as a specific phase of “spiritual crisis” or insecurity is mostly a matter only of Catholic priests or can also be found in other pastoral professionals. Methods: In a cross-sectional survey, we measured the prevalence of spiritual dryness in non-ordained Catholic pastoral workers, and identified relevant predictors. Results: In a sample of 3.277 pastoral workers, 50% would occasionally experience phases of spiritual dryness, while 13% experience it often or even regularly. There were no significant differences between women and men, professions, or age groups. The best predictors of spiritual dryness were low transcendence perception and a low sense of coherence (both are resources), as well as depressive symptoms and stress perception (both are demands or stressors), which would explain 41% of the variance. Self-efficacy expectation and social support were not among the significant predictors. Conclusion: Both the proportions and the main predictors are similar compared to Catholic priests. It is thus not the underlying profession or vocation and the related life situation or differences in social support, but predominantly specific perceptions, feelings, and attitudes that are related to the phenomenon of spiritual dryness—and these can be found in all pastoral professionals who seriously live their spirituality.