What institutional structures, spiritual care practices, and training processes will enable hospital chaplaincy to achieve its highest potential in caring for the sick?
The hospital chaplaincy and medicine project is comprised of a consortium of researchers and hospital chaplaincy departments at the Harvard teaching hospitals including Brigham and Women's Hospital, Massachusetts General Hospital, Dana-Farber Cancer Institute, and the Beth-Israel Deaconess Medical Center. The consortium includes chaplaincy research mentorship and seminar-based education in empirical research in the area of chaplaincy and spiritual care. A goal of the consortium is to grow empirical research in chaplaincy services and investigate the impact of chaplaincy spiritual care on outcomes including spirituality and medical utilization. The project intends to strengthen and grow the field of chaplaincy through cutting-edge, outcomes research.
Hospital Chaplaincy and Medical Outcomes at the End of Life
Spiritual care, including hospital chaplaincy services, has been shown to predict important patient end-of-life outcomes, including patient quality of life and health care services utilization near death. Due to such data, national palliative care guidelines include spiritual care as a key domain of palliative care. However, data are unavailable to characterize how hospital chaplaincy spiritual care is associated with these patient outcomes. Such data are necessary to elucidate the role of chaplaincy within the provision of palliative care and to characterize the key content of chaplaincy spiritual care to patients with advanced illness. This project aims to characterize how hospital chaplaincy spiritual care prospectively influences end-of-life outcomes among advanced cancer patients. The project adds supplemental chaplaincy survey information to the NCI/NIH-funded Coping with Cancer II study—a prospective, multi-regional, racially diverse cohort study of 600 advanced cancer patients—assessing end-of-life communication and medical outcomes in the final month of life. The project prospectively characterizes the relationship between chaplaincy spiritual care, characterized by both its intensity (i.e., frequency of visits) and spiritual care content (e.g., religious ritual, life review), and patient end-of-life outcomes including quality of life and health care services utilization in the last month of life (e.g., hospice enrollment, receipt of aggressive, futile medical interventions, and health care costs). The study also explores potential mediating factors in these relationships, such as spiritual peace and acceptance of illness. Finally, the study includes a mixed quantitative-qualitative component to assess key chaplaincy services themes and content viewed as beneficial by patients. The study is a cost-effective and unique opportunity, leveraging the infrastructure of a comprehensive, multisite longitudinal NIH-funded study to explore the relationship of hospital chaplaincy services to notable patient end-of-life outcomes. Findings from the study will serve to advance the understanding of chaplaincy services within the provision of palliative care by guiding chaplaincy’s role and spiritual care content in optimally caring for patients with serious illness. Funded in part by the Healthcare Chaplaincy of NYC.