Search

There is interest in chaplains devoted to outpatient cancer care, informed by a growing body of research as well as recommendations of accreditors. Simultaneously, a growing share of U.S. healthcare is faith-based and possesses a foundational interest in religious/spiritual (R/S) care due to institutional culture. In that milieu, few articles describe how religious organizational cultures influence the creation and implementation of FTEs intended to meet the evidence-based recommendations of accreditors. This is a lacuna, given that board certified chaplains are measured on their ability to integrate spiritual care into the life and service of their institutions. In response, this article describes the creation and implementation of two chaplain positions devoted to a group of outpatient cancer clinics in a large Catholic healthcare system. This includes lessons learned when navigating R/S aspects of organizational cultures while implementing and executing chaplain practice to meet accreditor recommendations.

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.

Objectives: This pilot study explores how healthcare leaders understand spiritual care and how that understanding informs staffing and resource decisions., Methods: This study is based on interviews with 11 healthcare leaders, representing 18 hospitals in 9 systems, conducted between August 2019 and February 2020., Results: Leaders see the value of chaplains in terms of their work supporting staff in tragic situations and during organizational change. They aim to continue to maintain chaplaincy efforts in the midst of challenging economic realities., Conclusions: Chaplains' interactions with staff alongside patient outcomes are a contributing factor in how resources decisions are made about spiritual care.

The Covid-19 pandemic has negatively affected the three basic needs of individuals. Faith-based organization leaders are carrying the additional weight of stewardship of members during these challenging times. Many Faith-based organization leaders feel a sense of responsibility to create environments where members feel a sense of belonging. Five considerations for Faith-based organization leaders hoping to increase belonging are discussed below. Specifically, low-cost options are presented that could be implemented in small-to-large Faith-based organizations.

In Alberta, Canada, supervised pastoral education has grown and thrived for over 50 years. In 2008, due to healthcare funding changes, it was nearly eliminated. This article describes regenerative processes by which former structures have transformed into a new configuration for supervised pastoral education program delivery, including innovative roles for spiritual care preceptors and theological colleges. Out of the ashes, a phoenix is rising. It is called the Alberta Consortium for Supervised Pastoral Education program.

Two nurses, a mother and daughter, each participated in disaster relief efforts after Hurricane Andrew in 1992 and Hurricane Dorian in 2019. In recounting their experiences, both nurses demonstrate the vital contributions nurses can make at the sites of disasters. The invaluable role of churches in contributing to the disaster recovery effort is also described.

Spirituality is a key focus and ethical obligation of nursing practice, but many nurses express uncertainty or discomfort with this aspect of their role. The purpose of this article is to explore the domains of religion, spirituality, and culture as commonly conceptualized by chaplains, as a framework for nurses to provide spiritual care interventions to patients in acute care hospitals. Using anecdotes and illustrations from palliative care practice, this article discusses the enhanced benefits to patients and families when spiritual needs are addressed, with specialty-level chaplain interventions, primary spiritual interventions provided uniquely by nurses, or interventions that require the cooperation of both professions. Lessons learned from the inpatient palliative care team experience can also apply to chaplaincy and nursing care for patients in settings beyond the acute care hospital and in disciplines beyond palliative care.

Objective: To describe an Indigenous Samoan psychosocial intervention developed to address the mental health needs of affected communities in Samoa following a tsunami., Method: A partnership was established between Samoan therapists, Samoan Catholic pastoral workers and non-Samoan mental health clinicians, informed by Samoan concepts of self and wellbeing. The format developed for visits to significantly affected households was based on a Samoan cultural practice known as asiasiga and was carried out by pastoral workers, with daily group supervision and access to mental health professionals., Results: Household visits were offered to affected families in villages throughout southern and eastern Upolu and the island of Manono. There was a high degree of acceptance of the programme by Pulenu'u (village governance leaders) and family leaders and members., Conclusions: Mental health responses to the needs of Indigenous Pacific communities following a disaster need to be embedded in the values of those communities. The Samoan practice of asiasiga contributed to the high degree of acceptability of this programme. Partnerships with churches, schools and other local organisations are likely to enhance acceptability and participation. More research is required on Indigenous Pacific post-disaster mental health programmes.

Objective: To describe a community-based single-session group intervention designed to address psychosocial needs of Samoan young people following a tsunami., Method: This programme resulted from collaboration between Samoan therapists, Samoan Catholic pastoral care workers and non-Samoan mental health clinicians. Informed by Samoan concepts of self and wellbeing, it incorporated cultural and spiritual practices familiar to Samoan young people and their families as well as body-centred therapeutic techniques, the 'Tree of life' exercise and provision of a cooked meal., Results: Following household visits to affected families in villages throughout southern and eastern Upolu and the island of Manono, the programme was devised and carried out in 11 villages with 1295 children participating. There was a high degree of acceptance of the programme by Pulenu'u (village governance leaders), young people, their families and community members., Conclusions: Interventions to address the psychological needs of Indigenous Pacific children and adolescents following a major disaster need to be embedded in the values of their communities. This paper describes an innovative programme based on Samoan values that was consistent with evidence-informed principles used to guide post-disaster responses.

Purpose: This paper aimed to discover the requirements of hospital-based spiritual care for cancer patients., Methods: This study was a descriptive qualitative-exploratory research, in which 25 participants were selected through purposive sampling and had semi-structured interviews., Result: The data analysis revealed 3 themes and 8 sub-themes including fundamental requirements (changes in the attitudes and behaviors of the healthcare team), structural requirements (inter-professional collaborations, a reference system), and functional requirements (religious-spiritual, pastoral, psycho-spiritual, and supportive-spiritual care). In this study, the received topics have been related to the spiritual care which can help improve patient care., Conclusion: The results were added to the repertoire of knowledge about the spiritual needs of cancer patients. The results indicated that it is essential to get acquainted with the spiritual care requirements in the hospital and enforce them through inter-professional collaboration. Accordingly, the spiritual care program should be designed, implemented, and evaluated.

This study examines VA chaplains' understandings of moral injury (MI) and preferred intervention strategies. Drawing qualitative responses with a nationally-representative sample, content analyses indicated that chaplains' definitions of MI comprised three higher order clusters: (1) MI events, (2) mechanisms in development of MI, and (3) warning signs of MI. Similarly, chaplains' intervention foci could be grouped into three categories: (1) pastoral/therapeutic presence, (2) implementing specific interventions, and (3) therapeutic processes to promote moral repair. Findings are discussed related to emerging conceptualizations of MI, efforts to adapt existing evidence-based interventions to better address MI, and the potential benefits of better integrating chaplains into VA mental health service delivery.

In 2009 a Consensus Conference of experts in the field of spiritual care and palliative care recommended the inclusion of Board-certified professional chaplains with at least 1,600 hours of clinical pastoral education as members of palliative care teams. This study evaluates a clinical pastoral education residency program's effectiveness in preparing persons to provide spiritual care for those with serious illness and in increasing the palliative care team members' understanding of the chaplain as part of the palliative care team. Results showed chaplain residents felt the program prepared them to provide care for those with serious illness. It also showed that chaplain residents and palliative care team members view spirituality as an integral part of palliative care and see the chaplain as the team member to lead that effort. Suggested program improvements include longer palliative care orientation period, more shadowing with palliative care team members, and improved communication between palliative care and the chaplain residents.

Stereotypes of religious professionals can create barriers for those who provide spiritual/pastoral care. Through interviews and journal entries, hospice chaplains ( n = 45) identified the following stereotypes that affected their work: chaplains as people whom others try to impress, who only talk about spiritual and religious topics, who are male, and who try to convert others. Participants reported using a variety of communication strategies to counteract stereotypes and make meaningful connections with the people they serve.

This column describes the development, implementation, and outcomes of a quality improvement learning collaborative that aimed to better integrate chaplaincy with mental health care services at 14 participating health care facilities evenly distributed across the U.S. Department of Veterans Affairs and Department of Defense. Teams of health care chaplains and mental health professionals from participating sites sought to improve cross-disciplinary service integration in six key domains: screening, referrals, assessment, communication and documentation, cross-disciplinary training, and role clarification. Chaplains and mental health providers across all facilities at participating sites were significantly more likely post-collaboration to report having a clear understanding of how to collaborate and to report using a routine process for screening patients who could benefit from seeing a professional from the other discipline. Foundational efforts to enhance cross-disciplinary awareness and screening practices between chaplains and mental health professionals appear particularly promising.

During Jesus' healing ministry, he addressed the diseases of his day, particularly the conditions that ostracized people, such as demon possession, paralysis, hemorrhage and blindness. This healing ministry is much of our focus in Catholic health care, as it should be. But Jesus addressed the deeper stories that surrounded the people he healed. He challenged his listeners to recognize the role they played in creating their own narrative of disease and their communities' norms in responding to illness. He did not shy away from separating the afflicted person's illness from moral failings or character weakness. He was clear about calling out institutional practices that marginalized people. In short, Jesus called out injustice when he saw it, and his healing was tied up in these social statements.

This article addresses two major African-American congregational care needs: (1) helping suffering people to access sustained mental health care, particularly in a large/mega-church; and (2) helping suffering people with multi-layered challenges to access appropriate, skilled care that transcends traditional barriers and is consistent with their faith. One model of congregational care is presented with concrete examples of how cultural, theological, and strategic concerns are discussed, with broad implications for diverse faith communities., (© The Author(s) 2016.)

Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer., (© The Author(s) 2016.)

In 2015, there were 43.5 million informal, unpaid caregivers in the United States. Caregivers reported a moderate to high level of burden of care, including performing medical and nursing tasks they were not trained to do. A study of family caregiver experiences with parish/faith community nurses reveals four key ways parish nurses support caregivers and offers important implications for parish nurse preparation and practice.

Background: There is an urgent need to develop an evidence base for children's palliative care (CPC) globally, and in particular in resource-limited settings. Whilst the volume of CPC research has increased in the last decade, it has not been focused on countries where the burden of disease is highest. For example, a review of CPC literature in sub Saharan Africa (SSA) found only five peer-reviewed papers on CPC. This lack of evidence is not confined to SSA, but can be seen globally in specific areas, such as an insufficient research and evidence base on the treatment of pain and other symptoms in children. This need for an evidence base for CPC has been recognised for some time, however without understanding the priorities for research in CPC organisations, many struggle with how to allocate scarce resources to research., Method: The International Children's Palliative Care Network (ICPCN) undertook a Delphi study between October 2012 and February 2013 in order to identify the global research priorities for CPC. Members of the ICPCN Scientific Committee formed a project working group and were asked to suggest areas of research that they considered to be important. The list of 70 areas for research was put through two rounds of the Delphi process via a web-based questionnaire. ICPCN members and affiliated stakeholders (n = 153 from round 1 and n = 95 from round 2) completed the survey. Participants from SSA were the second largest group of respondents (28.1 % round 1, 24.2 % round 2) followed by Europe., Results: A list of 26 research areas reached consensus. The top five priorities were: Children's understanding of death and dying; Managing pain in children where there is no morphine; Funding; Training; and Assessment of the WHO two-step analgesic ladder for pain management in children., Conclusions: Information from this study is important for policy makers, educators, advocates, funding agencies, and governments. Priorities for research pertinent to CPC throughout the world have been identified. This provides a much needed starting place for the allocation of funds and building research infrastructure. Researchers working in CPC are in a unique position to collaborate and produce the evidence that is needed.

Background: Chaplains are increasingly seen as key members of interdisciplinary palliative care teams, yet the specific interventions and hoped for outcomes of their work are poorly understood. This project served to develop a standard terminology inventory for the chaplaincy field, to be called the chaplaincy taxonomy., Methods: The research team used a mixed methods approach to generate, evaluate and validate items for the taxonomy. We conducted a literature review, retrospective chart review, focus groups, self-observation, experience sampling, concept mapping, and reliability testing. Chaplaincy activities focused primarily on palliative care in an intensive care unit setting in order to capture a broad cross section of chaplaincy activities., Results: Literature and chart review resulted in 438 taxonomy items for testing. Chaplain focus groups generated an additional 100 items and removed 421 items as duplications. Self-Observation, Experience Sampling and Concept Mapping provided validity that the taxonomy items were actual activities that chaplains perform in their spiritual care. Inter-rater reliability for chaplains to identify taxonomy items from vignettes was 0.903., Conclusions: The 100 item chaplaincy taxonomy provides a strong foundation for a normative inventory of chaplaincy activities and outcomes. A deliberative process is proposed to further expand and refine the taxonomy to create a standard terminological inventory for the field of chaplaincy. A standard terminology could improve the ways inter-disciplinary palliative care teams communicate about chaplaincy activities and outcomes.

Fundamental Christianity and psychology are frequently viewed as incompatible pursuits. However, proponents of the integrationist movement posit that pastoral counselors can utilize principles from psychology if they adopt the premise that all truth is God's truth. Assuming this perspective, Cognitive-Existential Family Therapy (CEFT) - a theoretical integration model compatible with Christian fundamentalism - is proposed. The philosophical assumptions and models of personality, health, and abnormality are explored. Additionally, the article provides an overview of the therapeutic process., (© The Author(s) 2015 Reprints and permissions:sagepub.co.uk/journalsPermissions.nav.)

Hospital chaplaincy and spiritual care services are important to patients' medical care and well-being; however, little is known about healthcare providers' experiences receiving spiritual support. A phenomenological study examined the shared experience of spiritual care between hospital chaplains and hospital-based healthcare providers (HBHPs). Six distinct themes emerged from the in-depth interviews: Awareness of chaplain availability, chaplains focus on building relationships with providers and staff, chaplains are integrated in varying degrees on certain hospital units, chaplains meet providers' personal and professional needs, providers appreciate chaplains, and barriers to expanding hospital chaplains' services. While HBHPs appreciated the care received and were able to provide better patient care as a result, participants reported that administrators may not recognize the true value of the care provided. Implications from this study are applied to hospital chaplaincy clinical, research, and training opportunities.

This article focuses on the institutional dimensions of spiritual care within hospital settings in the context of the Patient Protection and Affordable Care Act of 2010 (ACA), applying policy information and systems theory to re-imagine the value and function of chaplaincy to hospital communities. This article argues that chaplaincy research and practice must look beyond only individual interventions and embrace chaplain competencies of presence, ritual, and communication as foundational tools for institutional spiritual care.

Background: Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains' current and potential roles in caring for veterans and service members with mental health needs., Objective: Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings., Design: A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains., Participants: Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities., Main Measures: Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete., Key Results: When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8-100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved., Conclusions: Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.

Person-centred health and person-centred care have gained prominence across the UK following the publication of reports on public inquiries exploring failings in care. Self-awareness and participation in reflective practice are recognised as vital to supporting the person-centred agenda. This article presents an education framework for reflective practice, developed and used in one NHS board in Scotland, and based on the tenets of the clinical pastoral education movement. Providing an insight into the usefulness of a spiritual component in the reflective process, the framework provides an opportunity for nurses and other healthcare professionals to examine the spiritual dimensions of patient encounters, their own values and beliefs, and the effect these may have on their practice.

Research into the area of resilience provides a challenge and a great opportunity for professional chaplaincy. In this article, we will consider the challenge that the research primarily of George Bonanno of Columbia University offers to the traditional, clinical perspectives and assessments of professional chaplains serving in health care. Secondly, we will propose the practical implications for a wider paradigm and an expanded focus on intentionality and interventions of chaplains. Resilience is seen as a positive response possibility for those facing potentially traumatic events. It is understood to be a predominant response to traumatic events more often than the grief recovery model usually presumed to be active. Resilience has heuristic value and merits being factored in to professional chaplaincy as it relates to patient assessment, interventions, interdisciplinary care, staff and corporate support, and transcultural usefulness.

Recently, Christian pastoral care and psychotherapy have shown an increasing interest in embracing each other more than ever before. Theoretical clarity is essential both to maintain the individual identities of the two disciplines and to help practitioners select and apply appropriate resources from each other's discipline when necessary. This article aims to contribute to the limited body of literature by discussing some of the exemplary theoretical commonalities of the two disciplines as well as their distinctions. A review of the existing literature, enriched with practical pastoral experiences and academic work of the authors will help to clarify some of the basic philosophical and anthropological assumptions that have impacts on the actual practices of the two disciplines.

As the number of Clinical Pastoral Education students increases, supervisors in the Association for Clinical Pastoral Education (ACPE) are in short supply due to retirements. We explore factors associated with this supply problem, reporting here four results from our survey of active and retired supervisors. We identify the ages of the current supervisory pool, the ages at which supervisors were certified and the length of time spent in the supervisory education program across the decades. The survey results also identify what supervisors perceive as the most helpful components of their supervisory education. These four results identify trends across the decades that may be associated with the present and future shortages of supervisors.

Chaplains play important roles in caring for Veterans and Service members with mental health problems. As part of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Integrated Mental Health Strategy, we used a sequential approach to examining intersections between chaplaincy and mental health by gathering and building upon: 1) input from key subject matter experts; 2) quantitative data from the VA / DoD Chaplain Survey (N = 2,163; response rate of 75% in VA and 60% in DoD); and 3) qualitative data from site visits to 33 VA and DoD facilities. Findings indicate that chaplains are extensively involved in caring for individuals with mental health problems, yet integration between mental health and chaplaincy is frequently limited due to difficulties between the disciplines in establishing familiarity and trust. We present recommendations for improving integration of services, and we suggest key domains for future research.

Objective: To evaluate whether the evidence-based Body & Soul program, when disseminated and implemented without researcher or agency involvement and support, would achieve results similar to those of earlier efficacy and effectiveness trials., Design: Prospective group randomized trial., Setting: Churches with predominantly African American membership., Participants: A total of 1,033 members from the 15 churches completed baseline surveys. Of these participants, 562 (54.4%) completed the follow-up survey 6 months later., Intervention: Church-based nutrition program for African Americans that included pastoral involvement, educational activities, church environmental changes, and peer counseling., Main Outcome Measure: Daily fruit and vegetable (FV) intake was assessed at pre- and posttest., Analysis: Mixed-effects linear models., Results: At posttest, there was no statistically significant difference in daily servings of FVs between the early intervention group participants compared to control group participants (4.7 vs 4.4, P = .38). Process evaluation suggested that added resources such as technical assistance could improve program implementation., Conclusions and Implications: The disseminated program may not produce improvements in FV intake equal to those in the earlier efficacy and effectiveness trials, primarily because of a lack of program implementation. Program dissemination may not achieve public health impact unless support systems are strengthened for adequate implementation at the church level., (Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Diversity education in clinical training such as CPE is best developed in an interactive group context, guided by methods and approaches promoting mutual disclosure that includes the leader. Each member is invited to portray a web of meaning with cultural, spiritual and religious threads that comprise a personally knitted reality, a narrative foundational to identity and interaction. Differences between people in the training context challenge previously held notions, distribute authority in the group and foster open ended learning that enriches the activities of clinical supervision. This article describes group educational methods with case examples that foster spiritual/cultural competency, each member a person in context with the opportunity to be distinct and connected, a threshold for all other dimensions of diversity learning in pastoral practice.

Nineteen newly certified Association for Clinical Pastoral Education (ACPE) Associate Supervisors were interviewed to determine how they learned to do Clinical Pastoral Education (CPE) supervision. Grounded theory was the qualitative research method used in gathering and analyzing data for this IRB approved study. The emerging theory, Mutually Engaged Supervisory Processes, includes nine processes: Discerning Vocation, Feedback, Support, Supervisory Practices and Identity, Theory, Increased Awareness, Shift in Personhood, Offering Presence, and Owning Authority. Member checks confirmed the trustworthiness of the results.

Noting the rapid evolution of pastoral care in American hospitals and culture, the author embraces and explicates the shift toward an inclusive and holistic model of spiritual care that has ramifications for care delivery and clinical education.

Purpose of Review: The role of chaplains/spiritual care professionals and the importance of addressing spiritual needs within interdisciplinary oncology teams are in need of systematic review and critical appraisal. This review focuses on four key areas: basic concepts of spirituality within the healthcare domain; the relevance of spirituality within cancer care; the role of spiritual care within interdisciplinary cancer teams; and the current status of spiritual care professionals in interdisciplinary cancer teams., Recent Findings: Addressing cancer patient's spiritual issues is recognized as a component of comprehensive cancer care. Spirituality has a positive effect on subjective and emotional aspects of cancer patient's health, including quality of life, wellbeing and distress. Failing to address cancer patients spiritual needs impacts patient wellbeing, satisfaction with care, perceived quality of care and is associated with higher healthcare costs. Although a variety of disciplines address spiritual issues, spiritual care professionals are recognized by patients, clinicians, researchers and within best practice guidelines of national health councils as specialists within this domain., Summary: Spiritual care professionals are increasingly recognized as integral members of interdisciplinary oncology teams. However, the full integration of spiritual care professionals within the standard practice of oncology interdisciplinary teams is lacking, as spiritual care services continue to be treated as ancillary services within cancer care organizations.

There is growing evidence that leaders in professional health care chaplaincy recognize the important role of research. The Standards of Practice recently approved by the Association of Professional Chaplains (APC), and especially the standard about research (Standard 12), provide strong evidence that the profession sees research, and research-literate chaplains, as important for its future. The aim of this study was to identify the extent to which Association for Clinical Pastoral Education, Inc (ACPE) accredited clinical pastoral education (CPE) residency programs are preparing their graduates to be the kind of research-literate chaplains described in these Standards. We interviewed CPE supervisors from 26 randomly-selected CPE residency programs. We found 12% of the programs had intentional and substantive research-related curricula, 27% of the programs offered some limited exposure to research, and 62% of the programs provided no education about research. We found also that supervisors often defined "research education" in terms of actually conducting research projects. CPE residency programs potentially play a central role in educating research-literate chaplains. Future research should examine the incentives and barriers that influence the inclusion of research education in CPE residency programs.

When Chaplaincy and Psychiatry examine their own methodologies, do they work to reduce age-old barriers, thereby involving each other to promote holistic patient care? Chaplaincy trains in self-awareness and pastoral care specializing in religion, spirituality, grief and loss; while Psychiatry trains in medicine, neurology, and the behavioral neurosciences. Relationships across disciplines with common interests are vital. Ongoing dialogue between these professions will enhance the shared goals of coping and healing in the communities they serve.

This paper surveys the field of Judaism and health. The authors trace the history of discourse on health and healing within Judaism, from the biblical and rabbinic eras to contemporary research and writing on Jewish bioethics, pastoral care, communal services, and aging, including congregational and community programming related to health and illness and the emergence of the Jewish healing movement. The work of the Kalsman Institute on Judaism and Health is described, focusing on efforts to unite these various threads into a scholarly field emphasizing basic and applied research on the instrumental functions of Jewish religious life for health and well-being.

Health care chaplaincy needs to develop a body of published case studies. Chaplains need these case studies to provide a foundation for further research about the efficacy of chaplains' spiritual care. Case studies can also play an important role in training new chaplains and in continuing education for experienced chaplains, not to mention educating health care colleagues and the public about the work of health care chaplains. Guidelines for writing case studies are described, herein, as is a project in which three experienced oncology chaplains worked together to write case studies about their work. Steps that chaplains, and professional chaplain organizations, can take to further the writing and publishing of case studies are described.

This article deals with the Church of Sweden and the Church of Finland and their spiritual support for parishioners during their end-of-life phase. Support for the dying seemed uncommon in both countries, while most parishes offered support for the bereaved. The Finnish respondents expressed more confidence in their spiritual role than did the Swedes. This may have to do with the role of the churches in their respective countries and the varying geographies of death.

Although meeting patients' spiritual needs is important, many nurses are uncertain about what spiritual care involves and lack confidence in this area. This second article in a two part series on spirituality considers ways of addressing spiritual needs and provides an overview of the principles of assessment and implementation. Part 1 explored definitions of spirituality, the difference between religion and spirituality, and finding meaning in illness.

Despite its importance in end of life care, spiritual care is poorly addressed. This article presents the results of an innovative service in which nurses notify hospital chaplains of all patients placed on the Liverpool Care Pathway and the chaplains then visit to offer spiritual support to both patients and their carers. Nurses reported that the service was valuable not only for patients and their families but also for themselves and the whole clinical team. All nurses said they wanted the service to continue.

Background: Little research has explored parish nurses' perceptions of their preparation for their new role transition. This article studied role preparation from the perspective of practicing parish nurses., Methods: A qualitative descriptive design used in-person interviews and open-ended questions. Interviews with practicing parish nurses within 2 years of attending a training course were transcribed and coded. Participants shared their perceptions of role preparation and the interventions that were most helpful in transitioning to the role of parish nurse., Results: Participants identified some deficiencies in training that led to feelings of inadequacy in areas such as spirituality and community nursing knowledge. Lack of role models and inadequate practice hours were challenges for role transition. Group activities during training and peer support were cited as helpful interventions for the new parish nurse., Conclusion: The findings will help parish nurse educators to understand factors that affect role transition for parish nurses and contribute to the improvement of training models to support successful role transition.