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Healthcare workers (HCWs) experience occupational stressors that negatively impact emotional well-being and exacerbate turnover intentions. In the wake of the COVID-19 pandemic, the resultant acute care turnover rates have reached an all-time high. In addition, occupational stressors lead to psychological stress, including moral distress, defined as the dissonance between perceiving what the right course of action is and encountering an obstacle to acting accordingly. This qualitative descriptive study explored the perceptions of patient-facing HCWs in acute care hospital settings regarding the workplace stressors they encountered and the role of hospital-based chaplains in addressing emotional well-being and stress with 33 interviews. Findings suggest that HCW frequently experience work-related moral distress and seek relief by interacting with hospital chaplains. Chaplain care, common in American healthcare facilities for the spiritual care of patients, is an easily accessible resource to HCWs. Facilitating chaplain-HCW interactions may be an effective strategy for responding to moral distress and improving healthcare workers' well-being., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

While the relationship between crime, prisons and religion has been the subject of extensive research, the contemporary role and impact of prison chaplaincy remains a relatively under-explored area of study. This systematic literature review explored the role and impact of the prison chaplain. The role included pastoral and emotional support as well as religious, practical, and educational input. The impact included rehabilitation, creation of communities, calm, forgiveness and atonement., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The Pastoral Care department at Mercy Medical Center in Baltimore embarked on an evidence-based practice (EBP) project to identify best practices for improving nurses' well-being. This article describes the EBP model and its application. The project resulted in increased nurse awareness of the chaplain's role, nurses' confidence in using chaplain services, and nurses' well-being. The project's success indicates the value of chaplains learning an EBP model and incorporating it into their practice., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This issue commences with a bibliometric analysis of the top 100 most cited articles on religion. It then presents the first of a two-part series relating to research from Poland and progresses to examine the relevance of religion and spirituality to public health. Finally, this issue revisits the long-established and productive discipline of healthcare chaplaincy and various factors relating to parish clergy. A new theme of mindfulness and prayer is also introduced., Competing Interests: Declarations Conflict of interest The authors have not disclosed any competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

In this article, we present a model of chaplaincy in a secular age which includes, in one coherent system: domain, goal and an intervention pathway. The domain is presented as the process of "responding to life itself". A corresponding goal of chaplaincy is considered in the context of "existential well-being". This goal can be achieved through the proposed "The Ritual Bath Model" based on these new defined concepts., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The purpose of this study was to assess the association between nurse religiosity and decision to consult spiritual care services at a hospital in the western USA. An anonymous survey was distributed to assess nurses' reports of whether they would request spiritual care services across different scenarios. Out of 171 nurses approached to participate in this survey, fifty-one nurses completed the survey and half of respondents considered themselves religious. Compared to non-religious nurses, religious nurses reported greater likelihood to contact a chaplain across a variety of patient and family scenarios, including when a patient has a new diagnosis, is anxious or depressed, or has a challenging family situation., Competing Interests: Declarations Conflict of interest Ms. Spilman received compensation for her work as a medical writing and research consultant. All other authors declare that there is no conflict of interest. Suggested Reviewers Ron Harvell, Charleston Southern University, rharvell@scuniv.edu, Joseph Ensign, University of Washington, bjensign@uw.edu, Faith Strunk, UT Houston, faith.a.strunk@uth.tmc.edu, Wendy Cadge, Brandeis University, Waltham, Massachusetts, wcadge@brandeis.edu., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

A longitudinal qualitative study was conducted to explore the experiences of church leaders (10 priests, pastors, and pastors' wives) who provided disaster spiritual/emotional care (DSEC) to the island of Puerto Rico during a period of intense and repeated crises from 2017 to 2022. Utilizing a narrative inquiry approach, 18 in-depth interviews were conducted and analyzed. Findings indicated that the participants engaged in psychological, social, and religious coping strategies to actively cope with the stress and trauma of being first responder rescuer/victims. Regional, cultural and contextual factors are considered in an effort to understand and enhance services to populations where disaster is the new normal., Competing Interests: Declarations Conflict of interest The authors declare an absence of any conflict of interest. Ethical Approval Ethics approval for this study was granted by Biola University’s Protection of Human Rights and Research Committee, and all protocols were carried out in line with the Declaration of Helsinki. Informed consent was reviewed and granted by each study participant. Participant data have been anonymized and maintained confidential. Consent for Publication The authors affirm that human research participants provided informed consent for publication of any interview quotes and personal information provided in Table 1., (© 2024. The Author(s).)

In this article, I chart the development of moral injury in the life of Rev. G.A. Studdert Kennedy, a well-known British Chaplain who served in the First World War. Studdert Kennedy did not benefit from contemporary insights on Moral Injury but intuitively followed a path toward healing that involved reflection, confession, penance and post-traumatic growth. Chaplain Studdert Kennedy's experience of moral Injury can inform our contemporary understanding and treatment of this debilitating malady., Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

As an interfaith hospital chaplain and a Christian, navigating the profound emotional terrain of grief and loss is both a professional duty and a deeply personal journey. Attending the funerals of two close friends has brought out the interplay between my role as a spiritual caregiver and my own vulnerability. In reflection, I realize the importance of self-care and the reminder that in offering comfort and empathy, I must first find it within myself.

Diversifying the chaplain workforce in hospital spiritual care departments and Clinical Pastoral Education (CPE) programs is essential for meeting the needs of a religiously diverse population in the USA. We interviewed seven total participants, including two Somali Muslim chaplain students and their Muslim and Christian chaplain educators in one CPE program. Participants described their personal journeys and motivations for pursuing careers in healthcare chaplaincy, their impact on hospitalized patients, and the role of expanding perspectives for those with little prior exposure to Somali Muslim faith leaders. Representation and linguistic diversity were viewed as positive attributes despite challenges of racial and religious discrimination. Recommendations include adjusting educational requirements for entry into the field to consider professional equivalencies; engaging community chaplains; and collaborating with local communities. These findings have important implications on creating pathways for spiritual care providers from underrepresented faith traditions to meet local community needs., Competing Interests: Declarations Conflict of interest The authors do not have any financial interests or benefits to disclose. Ethical Approval The formal determination by the Allina Health Institutional Review Board (IRB) was in the category of Non-Human Subjects Research and thus exempt from full IRB review. Consent to Participate Informed consent was obtained from all individual participants of the study., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Spiritual healthcare providers (e.g., chaplains) working in healthcare settings across the United States were surveyed with the goals of (1) understanding their awareness of aphasia (a language disorder affecting reading, writing, verbal communication, and auditory comprehension); (2) determining whether they have received any training in aphasia and what type of training has been received; (3) whether they altered their approach to assessing the spiritual well-being of a person with aphasia; and, (4) what tools were used to augment communication. From a convenience sample of 203 respondents, the results indicated that 96% of respondents had previously heard of aphasia and 85% of respondents correctly identified the definition of aphasia. Seventy-three percent of respondents (N = 128) altered their approach to spiritual well-being assessment due to the aphasia diagnosis. Most respondents did not indicate receiving any formal training related to aphasia., Competing Interests: Declarations Conflict of interest No potential competing interest is reported by the authors., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Abstract: During and following the COVID-19 pandemic, the world experienced a significant increase in the prevalence of mental health problems along with a concomitant increase in mental health service utilization rates. Even though the stigma associated with mental health problems has been decreasing and service utilization rates have increased, these have not been seen in all segments of the population; for instance, some religious beliefs have been associated with less frequent and lower rates of mental health service use. In this commentary, the authors, an academic psychiatrist and a community-based pastor, describe how their informal academic-community collaboration led to a series of speaking opportunities to help an international group of clergy members develop a better understanding of mental health and how mental health problems may intersect with faith. They reflect on lessons learned from these opportunities and their professions, discuss opportunities for academic faculty to apply these lessons in their daily practices, and encourage academic faculty to consider a "common ground" approach in their own community outreach efforts. The authors underscore the importance of building connections with people who might have beliefs, views, or understandings of medical concepts that differ from academic medicine's and of teaching trainees how to build these connections. They challenge individual clinicians and academic faculty to identify spheres of influence that they have in their own lives through which they can create a positive impact for medicine and public health by finding shared experiences and common ground, clarifying misunderstandings, educating where needed, and serving as role models to encourage trainees to do the same., (Copyright © 2024 the Association of American Medical Colleges.)

Professionals working with people after traumatic experiences are indirectly exposed to the consequences of trauma. The aim of the study was to establish the role of spirituality and optimism in the occurrence of secondary traumatic stress and growth among 104 Polish Catholic nuns caring for people with a disability. The study used 4 standard measurement tools. A multidimensional analysis identified four types of consequences. Nuns caring for people with disabilities are as vulnerable to secondary traumatization as other professionals working with traumatized people, but they are more likely to experience positive consequences of care, and this is thanks to their spirituality., Competing Interests: Declarations Conflict of interest The authors have not disclosed any competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The aim of this study was to document the longitudinal experiences of chaplains who served during both the early AIDS (1981-1995) and early COVID-19 (2020-2021) pandemics. A total of 11 hospital chaplains were interviewed across the USA and the United Kingdom. Interviews were analyzed using a Grounded theory approach. Chaplains reported multiple stressors during both pandemics, including barriers to integration into care teams, tensions with home religions institutions, burnout, and challenges arising from the politicization of disease. Despite these challenges, chaplains play a vital role during pandemics. Insights from their experiences can inform future strategies for compassionate crisis response., Competing Interests: Declarations Conflict of interest The authors have no relevant financial or non-financial interests to disclose. Ethical Approval This study was performed in line with the principles of the Declaration of Helsinki. Approval for this study was granted by the Johns Hopkins IRB (IRB00338369). Consent to Participate Informed consent was obtained from all individual participants included in the study. Consent to Publish The authors affirm that all study participants provided informed consent for publication of their statements, as well as the data contained in Tables 1 and 2., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Malocclusion refers to the departure from the normal relationship of teeth to other teeth in the same and opposing arch. It can negatively impact on facial appearance and the quality of life of a person. The present study aimed to investigate the influence of malocclusion on the role of priests as counsellors and preachers in Nigeria as perceived by church members. This was a cross-sectional survey of 112 church members who completed an electronic questionnaire. Thirty-five (31.3%) participants said unattractive dental appearance (malocclusion) will impact negatively on their acceptance of the priest's gospel message. Twenty-seven (24.1%) said dental appearance will influence the choice of priest that they go to for counselling while 71 (63.4%) said it will not. The study found that though unattractive teeth arrangement did not significantly affect the priest's duties as it pertains to sermons and counselling, awareness on the importance of orthodontic care among the clergy is necessary and should be encouraged among all spiritual leaders., Competing Interests: Declarations Conflict of interest The authors have no relevant financial or non-financial interests to disclose. Consent to Participate Informed consent was obtained from all individual participants included in the study. Consent to Publish The manuscript does not contain any individual person’s data in any form. Ethical Approval Ethical approval was obtained from the University of Nigeria Teaching Hospital Health Research and Ethics Committee. Approval number: UNTH/HREC2023/01/648., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Pain is a universal experience for hospitalized patients, with physical, psychological, spiritual, and cognitive implications. As hospitals seek to identify nonpharmaceutical options for managing acute pain, the role of chaplains has been overlooked. The purpose of this study was to evaluate the perceptions of nurses regarding chaplain involvement in pain management., Methods: A survey was distributed to nurses to determine if they would request spiritual care services in various patient and family scenarios. Respondents were dichotomized into two groups based on self-report of whether they would contact a chaplain for patients with uncontrolled pain. Differences between groups were calculated using chi-square tests., Results: Of 45 nurse respondents, 27 (60%) reported they would not contact a chaplain for patients with uncontrolled pain. Nurses who would consult the chaplain for pain management did not differ from nurses who would not consult the chaplain in terms of their own religious identification, knowledge of patient religious documentation in the medical record, or past experience with chaplain services., Conclusions: Study findings suggest that nurses' perceptions of chaplain involvement in pain management must be addressed prior to implementing a new hospital pain management protocol., Clinical Implications: When developing and implementing new pain protocols based on holistic care of patients, hospitals should ensure that nursing staff are educated on when and how to incorporate chaplains as part of a holistic approach to managing acute pain., Competing Interests: Declaration of competing interest Ms. Spilman received compensation for her work as a medical writing and research consultant. No other authors have conflicts of interest to disclose. This research did not receive any specific grants or funding from the public, commercial, or not-for-profit sectors. We confirm that this work entitled “Nursing and Chaplain Partnership for Pain Management: A Survey of Nurses” is original and has not been published elsewhere, nor is it currently under consideration for publication in another journal., (Copyright © 2024. Published by Elsevier Inc.)

As chaplaincy is increasingly practiced in outpatient settings, further understanding is needed of what it entails and is accomplishing within this unique context. This scoping review summarizes 42 articles that describe the types of spiritual care interventions and programs offered by chaplains in outpatient settings, and their outcomes. Findings support that chaplaincy is practiced in outpatient settings, especially in palliative care, oncology, and primary care. Interventions are delivered by chaplains as the sole interventionist, and by interdisciplinary teams with chaplain participants. Results show that outpatient chaplain interventions are feasible and acceptable, with positive psychological and spiritual outcomes. More studies with consistent outcome measurements, and structured chaplain interventions are needed to draw further conclusions about the effectiveness of outpatient chaplain interventions.

Palliative care chaplains conduct spiritual assessments for those within their care. This narrative review examined the literature concerning existing spiritual assessment models developed or designated for palliative care chaplain use. The literature review was performed using four databases, including a hand search of references due to the variability of keywords used within the spiritual care literature. Five spiritual assessment models were identified. The analysis of the models focused on three areas: (1) Foundational basis, (2) Spiritual needs, and (3) Structural frameworks. Published spiritual assessment models for palliative care chaplain use are variable in how each one was formed, how each tool describes and structures spiritual care needs, and how the models are implemented within their respective contexts. The PC-7 advances the field, especially through its mixed methods approach. Future validation and reliability research is needed as well as investigations concerning which models are taught by chaplain educators and used by palliative care chaplains.

The growing body of literature on religious and spiritual (R/S) struggles consistently highlights its association with various health outcomes in Pediatrics. Chaplains or spiritual care providers, as members of interdisciplinary teams, frequently offer spiritual care to patients and families grappling with R/S struggles. However, there is a paucity of literature demonstrating how chaplains address R/S struggle in their practice. This study aimed to construct a theory describing the process by which pediatric chaplains conceptualize and address it. Employing a constructivist Grounded Theory study design, we sought to comprehend the approaches pediatric chaplains utilize in addressing R/S struggles. Following a semi-structured interview guide, we interviewed twelve Board Certified or Board Certification-eligible chaplains. Findings reveal that chaplains use an iterative three-phase process to address R/S struggles. Thirteen categories emerged, which were further organized into four major themes: Assessing, Processing, Intervening, and Navigating Limitations. A model depicting this iterative process was constructed.

The study found that pastors who agreed they were trained to manage a church ranked high in ministry satisfaction and low in emotional exhaustion compared to those who disagreed to receiving such training. This work has implications for seminaries, congregations, denominational leaders and clergy themselves to ensure clergy are properly prepared and continue their career journey. This study could be used to modify curricula at seminaries and produce post seminary training and educational information., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Clergy play a crucial role in supporting the mental health of their congregants, but the impact on their own well-being is understudied. A review of 2019-2020 data from 636 U.S. religious leaders using generalized estimating equations analysis found that clergy use prayer, preaching, readings on mental health, and referrals to mental health professionals to support congregants' well-being. Future longitudinal studies are needed to understand the needs of diverse clergy groups., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

I am a Jewish chaplain and I felt moved to write this letter to my esteemed colleague Imam Sohaib Sultan, of blessed memory. Sohaib and I each experienced our first unit of Clinical Pastoral Education together as part of the same cohort in the summer of 2008. Sohaib died tragically in 2021. Here, I reflect on how we might respond to the current Israel-Hamas War., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Research suggests that religious/spiritual (R/S) matters take on increasing importance in later life and tend to be favorably associated with mental health, but religious doubt or uncertainty can undermine this salubrious relationship. Few studies assess whether social relationships, and the support contained within them, can mitigate these negative mental health consequences. The current study focuses on an important yet understudied social relationship in the context of spiritual struggles in later life: informal support from a religious pastor . Members of the clergy occupy a highly prestigious position in the church and are often a trusted resource for older adults as they confront problems., Design/participants: We use two waves of longitudinal data of Christian older adults in the Religion, Health, and Aging Study (2001-2004) from the United States ( N = 639) to test whether support from a pastor attenuates any detrimental mental health effects of carrying religious doubt in later life., Results: Results from lagged dependent variable models suggest that increases in religious doubt are associated with increases in depression over time, and that greater pastoral support attenuates the relationship between increases in religious doubt and depression, but only for men., Conclusions: We highlight the need for future research to explore this important social relationship with religious clergy for older adults in confronting both spiritual and secular challenges and the importance of considering gender differences in the process. We also suggest several practical implications for religious clergy, family members, and older adults in dealing with or helping others confront spiritual struggles.

Healthcare personnel experienced unprecedented stressors and risk factors for burnout, anxiety, and depression during the COVID-19 pandemic. This may have been particularly true for spiritual health clinicians (SHCs), also referred to as healthcare chaplains. We administered a daily pulse survey that allowed SHCs to self-report burnout, depression, and well-being, administered every weekday for the first year of the pandemic. We used a series of linear regression models to evaluate whether burnout, depression, and well-being were associated with local COVID-19 rates in the chaplains' hospital system (COVID-19 admissions, hospital deaths from COVID-19, and COVID-19 ICU census). We also compared SHC weekly rates with national averages acquired by the U.S. Census Bureau's Household Pulse Survey (HPS) data during the same timeframe. Of the 840 daily entries from 32 SHCs, 90.0% indicated no symptoms of burnout and 97.1% were below the cutoff for depression. There was no statistically significant relationship between any of the COVID-19 predictors and burnout, depression, or well-being. Mean national PHQ-2 scores were consistently higher than our sample's biweekly means. Understanding why SHCs were largely protected against burnout and depression may help in addressing the epidemic of burnout among healthcare providers and for preparedness for future healthcare crises.

Hospital-based chaplains provide crucial spiritual and emotional care to patients, families, and staff during times of intense life changes and crises. Chaplains are regularly exposed to suffering and their work may result in personal mental and emotional health challenges. To understand chaplains' perceptions of the impact of their work and methods to cope, a secondary analysis of a mixed-methods study on chaplain well-being was undertaken. Qualitative interviews were conducted with nine hospital-based chaplains and data were coded and analyzed using thematic analysis. Results revealed that participants perceive their work as offering both trials and rewards, and their efforts to cope with trials include interpersonal support, intrapersonal resources, and spiritual resilience. Personal insights into chaplains' experiences may help inform organizational interventions to support these essential members of the care team.

Ambulance staff wellbeing programs aim to support the bio-psycho-social and sometimes spiritual needs of paramedics. While evidence demonstrates strong connections between spirituality and/or religion to wellbeing outcomes, little is known about spiritual care in ambulance services or its impact. The aim of this study was to investigate paramedics' perspectives on the role and value of Australian ambulance chaplains. A cross-sectional online study of registered paramedics in Australia was conducted between November and December 2022. Analysis of the 150 responses identified that paramedics viewed the chaplain's role as one built on professional caring relationships that provided proactive and reactive care in paramedic workplaces. Chaplains were perceived to promote wellbeing by incorporating emotional, psychological, social and spiritual care, and assisting paramedics to access additional support. Perceived religiousness of chaplains and organisational factors were barriers to paramedics accessing chaplains, while pre-existing relationships and shared experiences positively influenced paramedics decision to seek chaplain support.

Healthcare chaplains address broad social and emotional dimensions of care within a pluralistic religious landscape. Although the development and evaluation of chaplaincy interventions has advanced the field, little research has investigated factors influencing the implementation of new chaplain interventions. In this mixed-method study, we examined attitudes about evidence-based interventions held by chaplain residents (n = 39) at the outset of an ACPE-accredited residency program in the southeast United States. We also used semi-structured interviews (n = 9) to examine residents' attitudes, beliefs, and decision-making processes after they trained in the delivery of a novel manualized intervention, Compassion-Centered Spiritual Health (CCSH). Most residents reported favorable attitudes toward manualized approaches prior to training. Interviews revealed complex decision-making processes and highlighted personal motivations and challenges to learning and implementing CCSH. Implementation science can reveal factors related to motivation, intention, and training that may be optimized to improve the implementation of healthcare chaplaincy interventions.

Introduction: Although clergy-perpetrated child sexual abuse (CSA) implies severe traumatic repercussions for the victims, they may also experience posttraumatic growth (PTG) deriving from the need to deal with the trauma suffered. This PTG is associated with the processes of recovery, healing, and empowerment., Objective: Applying a mixed methods approach to analyse PTG outcomes and to explore experiences of PTG in survivors of Spanish clergy-perpetrated CSA and its relation with psychosocial, mental and spiritual suffering., Participants: Thirty-one survivors (M = 51.6 years; SD = 12.4) in the quantitative stage of the research, and seven (M = 49.3; SD = 8.9) in the qualitative stage., Methods: A sequential explanatory mixed methods study design was applied using standardized questionnaires and semi-structured interviews. Descriptive, correlation and thematic analyses were conducted. The quantitative and qualitative data were integrated., Results: Positive associations were found between PTG and psychosocial and mental health problems (r = 0.53; p < .01), damage to faith in God (r = 0.43; p < .05) and damage to faith in the Church (r = 0.48; p < .01). Three themes emerged from the qualitative data that explained, expanded, and complemented the quantitative results, highlighting the relationship between damage and growth and the specific meanings of PTG from the perspectives of the survivors., Conclusions: This study shows that survivors may develop PTG in the course of the processes of psychological suffering, spiritual transformation, and meaning-making of traumatic experiences., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: Health care chaplains are faith providers with theological education, pastoral experience, and clinical training who provide spiritual care to patients, their families, and medical staff. This study sought to characterize chaplains' experiences providing spiritual care for patients experiencing abortion and pregnancy loss and to explore how chaplains gain competency and comfort in providing pastoral care for this patient population., Study Design: Researchers conducted in-depth, semistructured, qualitative interviews with currently-practicing chaplains recruited via convenience sampling in the Washington DC, Maryland, and Virginia region. We analyzed interviews using directed content analysis and coded using both inductive and deductive coding., Results: We interviewed 13 chaplains. The majority were Protestant and identified as Democrats. Participants often personally struggled with the acceptability of abortion but emphasized the importance of spiritual care for this patient population. They recognized that religious stigma regarding abortion prevented referrals to chaplaincy. Though desiring to contribute, chaplains reported little formal education in pregnancy support counseling. They relied on foundational pastoral care skills, like holding space, values clarification, connecting with patients' spirituality, words of comfort, ritualistic memorialization, and resource provision. All desired more training specific to abortion and pregnancy loss in chaplaincy education., Conclusions: Chaplains from varied faith backgrounds have a diverse set of skills to support patients experiencing abortion or pregnancy loss, but feel underutilized and lacking in formal training. Though not all patients require pastoral support, chaplains can be critical members of the care team, particularly for those patients experiencing spiritual distress., Implications: Chaplains have a paucity of training in supporting patients experiencing abortion and pregnancy loss. Chaplains want to be involved with patients experiencing abortion but feel excluded by both patients and practitioners. Standardization of pastoral care training is important to ensure adequate spiritual support for patients who desire such services., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Telehealth-based care models are being widely adopted by primary care providers and large healthcare institutions. Drawing on data collected at an international conference on the theory and practice of telechaplaincy, this article identifies and discusses how chaplains navigate various telechaplaincy-related challenges. A thematic analysis identified 49 codes and 11 themes at the individual-, organizational- and population levels. Presenters reported facing novel and qualitatively distinct challenges spanning an array of telechaplains' professional activities, including the structure of work routines, the types of interventions used, the ways provider-patient connections are established and experienced, the strategic positioning of chaplains, their role in the model of care, and ultimately, the populations served. It is argued that, though telechaplaincy has gained prominence since the Covid-19 pandemic, the maintenance of professional standards in digital care settings is a systemic challenge related to long-term trends towards outpatient care.

Background: Spirituality is an important component of social and cultural identity that influences health-related beliefs, decision-making, and coping behaviors. Despite the importance of addressing spirituality in healthcare, research about its impact is limited, especially in the primary care setting., Objective: This study aimed to explore patients' and chaplains' experiences of receiving or providing spiritual care in the primary care setting., Methods: We conducted an in-depth interview qualitative research study. Participants included patient informants, a chaplain, and chaplains-in-training who participated in a spiritual care program at a primary care clinic. Interviews were transcribed and coded. Conventional qualitative research content analysis was performed., Results: Eleven interviews were conducted - 7 with patient informants, 1 with a chaplain, and 3 with chaplains-in-training. Informants reported that in their experience spiritual care increased trust in their provider, made them feel safe to ask or share anything, improved their satisfaction with care, helped sustain healthy behavior change, and improved coping with chronic illness. Participants specifically attributed these positive experiences to chaplains' ability to respect and attend to patients' spirituality, create a safe space, help patients see the connection between their spirituality and health, and help patients tap into their own spirituality as a healthy means of coping., Conclusions: Spiritual care, when integrated into the primary care setting, has the potential, according to the report of our informants, to help achieve important health-related objectives, such as increased trust in their providers, sustained healthy behavior change, and happiness in spite of chronic illness. Now, more than ever, when our society is hurting from mistrust of our profession secondary to disinformation and discrimination, spiritual care has an important role to play in our efforts to gain our patients' trust so that we can support their healing., (© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.)

Background: Palliative Care also encompasses the dimension of spiritual pain. Pastoral care workers and chaplains are specialists in the provision of spiritual care. Decreasing religious affiliation and increasing spiritual diversification in modern societies raise the question of the function of pastoral care., Aim: The goal of this study is to answer the question of what pastoral care workers can offer to dying residents in hospices and palliative care units., Design: A qualitative interview study was designed to explore the specific perspective of pastoral care workers in a multidisciplinary environment. The study is based on differentiation theory which is particularly well adjusted to reveal differences in perspectives in so called 'holistic' care settings. The reporting follows the COREQ guidelines., Setting: Problem centered interviews were conducted at five hospices and two palliative care units., Results: Eight pastoral care workers were interviewed (5 Catholic, 3 Protestant, mean age of 58 years). The analysis of the interviews revealed three major themes: (A) Self-positioning in relation to the organization, (B) Offering conversations to patients and relatives, (C) Performing religious rituals. Minor themes were: mediating conflicts between patients, relatives and staff, sensing moods in silence with patients and organizing workshops for staff., Conclusion: In modern hospice care, pastoral care workers routinely address the problem of making death more tangible and of answering the unanswerable question of what comes afterwards. Through this, they support dying residents in hospices and palliative care units in dealing with the inexplicability of death., Competing Interests: Declaration of Conflicting InterestsThe author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This issue of JORH explores a broad range of topics looking at the professions of nursing, clergy and chaplains. This issue also concludes the series on Parkinson's disease (Part 2), and for the first time, JORH presents a collation of articles relating to workplace religiosity. Finally, this issue revisits the topics of women's health and family issues in relation to religiosity and spirituality., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The purpose of this observational study was to examine (a) the proportion of Catholic priests in the United States that have anxiety/depression and meet the Canadian 24-Hour of Movement Guidelines, and (b) the association of meeting these guidelines with the likelihood of anxiety and depression. A sample of (arch)diocesan priests (n = 335) completed demographic and behavior survey, International Physical Activity Questionnaire (IPAQ-SF), and Hospital Anxiety and Depression Scale (HADS). Results indicated that 21.1% of priests surveyed met all three movement guidelines (physical activity, sleep, and screentime) and 7.8% met none. Priests who reported excessive recreational screentime (≥ 3 h/day) were more likely to have anxiety (OR = 3.17) and depression (OR = 2.91), and who were physically inactive (< 150 min/week) were more likely to have depression (OR = 8.89). Data from this study addresses a gap in the literature regarding Catholic priests, movement behavior, and mental wellbeing., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Burnout syndrome implies exhaustion, loss of motivation, low performance, and absenteeism. Catholic clergy are not exempt. This systematic review compiles and analyzes evidence related to burnout in Catholic clergy and potential modulating variables. Following the PRISMA methodology, systematic searches in different scientific databases identified 17 studies, revealing that burnout is related to age, personality traits, and type of priesthood. No relation between burnout and social support, self-care, spiritual practice, or workload was detected. It is necessary to adapt conceptual models to the peculiarities of burnout among clergy, extending assessment strategies and introducing working and organizational perspectives in the analysis of modulating variables, and in the development of prevention and intervention programs., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Maintaining healthy behaviors is challenging. Based upon previous reports that in North Carolina (NC), USA, overweight/obese clergy lost weight during a two-year religiously tailored health intervention, we described trajectories of diet, physical activity, and sleep. We investigated whether behavior changes were associated with weight and use of health-promoting theological messages. Improvements were observed in sleep, calorie-dense food intake, and physical activity, with the latter two associated with weight loss. While theological messages were well-retained, their relationship with behaviors depended on the specific message, behavior, and timing. Findings offer insights into weight loss mechanisms, including the role of theological messages in religiously tailored health interventions., (© 2023. The Author(s).)

University chaplains are often unrecognised as resources in suicide prevention. This exploratory article highlights the valuable contributions university chaplains at one Australian university make to suicide prevention. Three overarching themes related to the contributions of university chaplains to suicide prevention were generated: (1) person-centred care; (2) the role of university chaplains in suicide prevention; and (3) professional development. Of particular note is that university chaplains actively contribute to all three phases of the suicide prevention framework: prevention, intervention, and postvention., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The ten-item Autism Spectrum Quotient (AQ10) is a self-report instrument originally designed to identify referrals for professional diagnosis for Autism Spectrum Disorders (ASD). Recent studies suggest that this instrument may also be tapping more generalised affective disorders. Working with this interpretation, this study examines the predictive power of the AQ10 to account for additional variance, after personal and personality factors have been taken into account, on the two scales of the Francis Burnout Inventory. Data provided by 220 Anglican clergy serving in Wales demonstrated that 8.6% of the participants recorded six or more red flags on the AQ10 (and so qualified for referral for specialist diagnostic assessment) and that higher scores on the AQ10 are associated with significantly lower levels of satisfaction in ministry and with significantly higher levels of emotional exhaustion in ministry. These data suggest that screening with the AQ10 may be helpful in identifying clergy vulnerable to professional burnout and to poor work-related psychological wellbeing, in addition to its primary purpose of screening for ASD., (© 2024. The Author(s).)

This article reports findings from an action research project in which a university chaplaincy team explored the desirability and viability of assessing their impact. It uncovers a complexity in chaplains' understandings about their role and - chief amongst their fears - belief that quantitative measures can be harmful to pastoral and spiritual work. It also reveals a sense of institutional accountability and a desire to engage with processes for determining and articulating chaplaincy's value., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Hospital chaplains routinely document the spiritual care they provide in patients' medical records, which is a useful and important practice. This article advocates two charting practices chaplains should change to better align our documentation with the beliefs and values of our profession., Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This article, the result of an Action Research project, describes the process of creating and testing a resource for assessing the contribution of chaplaincy in a British university setting, and the resultant insights and outcomes: organisational and individual learning, changes in chaplains' attitudes to monitoring and evaluation, and a resource which is perceived as having benefits and limitations. This article considers the evaluation process as applied to chaplaincy and offers a model for further testing., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Clergy from theologically conservative churches face challenges in providing counsel to LGBTQ (lesbian, gay, bisexual, transgender, and queer/questioning) congregants and use diverse strategies to address them. Thirty-three clergy from the Church of Jesus Christ of Latter-Day Saints participated in a qualitative survey. Results revealed that implementing church policy while simultaneously addressing the needs of LGBTQ congregants and diverging views posed challenges for clergy. Focusing on listening, love, and spiritual counsel while avoiding messages of defectiveness were helpful for LGBTQ congregants., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study sought to identify the occupational stressors Black pastors experience, who serve in Black Church denominations and Black nondenominational churches. A total of 218 pastors completed the survey out of 2786 for a response rate of 10.1%. Black pastors identified their most challenging stressors as member dynamics, financial stress, leading a church to fulfill its mission, and pastor's workload. Black women pastors faced the additional stressor of having their pastoral leadership challenged by male congregants. Black pastors faced more stressors during the COVID-19 pandemic including church closures, transitioning to virtual services, unexpected deaths, and an increased workload with 72.5% of pastors reporting moderate to extreme stress levels. Approximately 77% of pastors acknowledged experiencing from moderate to extreme stress levels during social protests for the deaths of Black people by law enforcement. Black pastors further acknowledged experiencing an additional three to six life stressors outside of their pastoral roles., (© 2023. The Author(s).)

Chaplains frequently serve as first responders for United States military personnel experiencing suicidal thoughts and behaviors. The Chaplains-CARE Program, a self-paced, e-learning course grounded in suicide-focused cognitive behavioral therapy principles, was tailored for United States military chaplains to enhance their suicide intervention skills. A pilot program evaluation gathered 76 Department of Defense (DoD), Veterans Affairs (VA), and international military chaplain learners' responses. Most learners indicated that the course was helpful, easy to use, relevant, applicable, and that they were likely to recommend it to other chaplains. Based on open-ended responses, one-quarter (25.0%) of learners indicated that all content was useful, and over one-quarter (26.3%) of learners highlighted the usefulness of the self-care module. One-third (30.3%) of learners reported the usefulness of the interactive e-learning features, while others (26.3%) highlighted the usefulness of chaplains' role play demonstrations, which portrayed counseling scenarios with service members. Suggested areas of improvement include specific course adaptation for VA chaplains and further incorporation of experiential learning and spiritual care principles. The pilot findings suggest that Chaplains-CARE Online was perceived as a useful suicide intervention training for chaplains. Future training can be enhanced by providing experiential, simulation-based practice of suicide intervention skills., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Police members can be exposed to morally transgressive events with potential for lasting psychosocial and spiritual harm. Through interviews with police members and police chaplains across Australia and New Zealand, this qualitative study explores the current role that police chaplains play in supporting members exposed to morally transgressive events. The availability of chaplains across police services and the close alignment between the support they offer, and the support sought by police, indicates they have an important role. However, a holistic approach should also consider organizational factors, the role of leaders, and access to evidence-based treatment in collaboration with mental health practitioners., (© 2023. The Author(s).)

Korean Americans are more likely to seek guidance from church leaders than to use traditional mental health services. Through semistructured key informant interviews with 16 Christian clergy members serving later-generation Korean Americans, the authors explored clergy members' perceptions of the mental health needs of their congregants. Insights from the study suggested that communication and collaboration between mental health professionals and church leaders may be helpful in addressing the Korean American community's emotional and mental health needs., Competing Interests: The authors report no financial relationships with commercial interests.

Pastoral counseling has been a significant part of the priestly ministry in the Philippines. Nonetheless, literature about Filipino priests' lived experiences and competencies in counseling is almost non-existent. Using Interpretative Phenomenological Analysis (IPA), the researcher explored the lived experiences and competencies of Filipino diocesan parish priests in their role as pastoral counselors. The study was framed in Phenomenology, the Philippines Psychology Act of 2009, and the 2009 competencies of the Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC), a division within the American Counseling Association (ACA). Data were collected using a semi-structured interview, and the analysis yielded seven (7) themes under three (3) clusters. The findings revealed that the participants lack the prerequisites to be rightfully called pastoral counselors. As priests continue to attend to people in need of counseling, the researcher calls on church leaders, the Psychological Association of the Philippines (PAP), and the Professional Regulation Commission (PRC) to address the practice of pastoral counseling in the country., Competing Interests: Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This article reports findings from a qualitative study of New York City faith leaders' efforts to mitigate the effects of the COVID-19 pandemic on their communities during the first two years of the pandemic. Faith leaders were recruited via reputational case sampling to participate in individual, key informant interviews. This study used a social-contextual approach to health promotion by exploring the influence of faith leaders and religious communities on health behaviors. Results suggest that engaged faith leaders worked individually and collaboratively to support the changing physical, emotional, and spiritual needs of their religious communities and those in the surrounding area. This study highlights the importance of faith leaders as supporters, communicators, and advocates, and provides directions for future research on the impact of faith leaders on individuals' experiences and health behaviors during a pandemic., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Research has consistently shown that the seeds of religiosity are planted and begin to take form during early life socialization, but little attention have been given to these dynamics among clergy members. In this study, we consider whether early life religious exposure may amplify the beneficial effects of spiritual well-being (having a "thriving" spiritual life) for mental health and burnout for clergy. Drawing from a life course perspective, we use longitudinal data from the Clergy Health Initiative, which sampled United Methodist Clergy in North Carolina (n = 1330). Key results suggest that higher frequencies of childhood religious attendance were consistently associated with lower depressive symptoms and burnout. The beneficial associations between spiritual well-being and lower depressive symptoms and burnout were also stronger for clergy with greater church attendance in childhood. The accumulation of "religious capital" for clergy who were raised in religious households with regular service attendance appear to accentuate the positive effects of spiritual well-being, which encompass a greater sense of closeness to God in their own lives and in ministry. This study identifies the importance of researchers taking a "longer" view of the religious and spiritual lives of clergy., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

From the gallows and fields of war to the street and bedside, chaplains of color have been present and instrumental in providing spiritual and emotional support in public and private settings across the United States. Their histories and experiences are not well documented and integrated into the field of spiritual care and chaplaincy, a field often understood as predominantly White, male, and Christian. This article introduces this special issue by offering historical context-particularly for Black chaplains-and naming the key themes that weave through the articles included. Naming the experiences of chaplains of color is a central step in responding to historically grounded racial inequities in the work of chaplaincy and spiritual care in the United States.