"Mein Herz hat mich nie im Stich gelassen!" Innere Bilder im Prozess der Inkorporation einestransplantierten Herzens

Harvey's modern insight into the archetypal idea of the heart as the centre of blood motion transforms the heart into a machine which becomes a spare part interchangeable from any chest to any other {[}Hillman]. As we try to show in the case of Elmar, a 41-year-old technician 2 years after his transplantation, the possibilities of cardiac surgery and its archetypal foundations do not exclude a personalized and symbolic vision of both the `old' heart and the `new' one. Intrapersonal and therapeutic issues of this `inter-cardiac conflict' are discussed

Developments in spiritual care education in German - speaking countries

Background: This article examines spiritual care training provided to healthcare professionals in Germany, Austria and Switzerland. The paper reveals the current extent of available training while defining the target group(s) and teaching aims. In addition to those, we will provide an analysis of delivered competencies, applied teaching and performance assessment methods. Methods: In 2013, an anonymous online survey was conducted among the members of the International Society for Health and Spiritual Care. The survey consisted of 10 questions and an open field for best practice advice. SPSS21 was used for statistical data analysis and the MAXQDA2007 for thematic content analysis. Results: 33 participants participated in the survey. The main providers of spiritual care training are hospitals (36%, n = 18). 57% (n = 17) of spiritual care training forms part of palliative care education. 43% (n = 13) of spiritual care education is primarily bound to the Christian tradition. 36% (n = 11) of provided trainings have no direct association with any religious conviction. 64% (n = 19) of respondents admitted that they do not use any specific definition for spiritual care. 22% (n = 14) of available spiritual care education leads to some academic degree. 30% (n = 19) of training form part of an education programme leading to a formal qualification. Content analysis revealed that spiritual training for medical students, physicians in paediatrics, and chaplains take place only in the context of palliative care education. Courses provided for multidisciplinary team education may be part of palliative care training. Other themes, such as deep listening, compassionate presence, bedside spirituality or biographical work on the basis of logo-therapy, are discussed within the framework of spiritual care. Conclusions: Spiritual care is often approached as an integral part of grief management, communication/interaction training, palliative care, (medical) ethics, psychological or religious counselling or cultural competencies. Respondents point out the importance of competency based spiritual care education, practical training and maintaining the link between spiritual care education and clinical practice. Further elaboration on the specifics of spiritual care core competencies, teaching and performance assessment methods is needed

Spiritual Dryness as a Measure of a Specific Spiritual Crisis in Catholic Priests: Associations with Symptoms of Burnout and Distress

Spirituality/religiosity is recognized as a resource to cope with burdening life events and chronic illness. However, less is known about the consequences of the lack of positive spiritual feelings. Spiritual dryness in clergy has been described as spiritual lethargy, a lack of vibrant spiritual encounter with God, and an absence of spiritual resources, such as spiritual renewal practices. To operationalize experiences of ``spiritual dryness'' in terms of a specific spiritual crisis, we have developed the ``spiritual dryness scale'' (SDS). Here, we describe the validation of the instrument which was applied among other standardized questionnaires in a sample of 425 Catholic priests who professionally care for the spiritual sake of others. Feelings of ``spiritual dryness'' were experienced occasionally by up to 40%, often or even regularly by up to 13%. These experiences can explain 44% of variance in daily spiritual experiences, 30% in depressive symptoms, 22% in perceived stress, 20% in emotional exhaustion, 19% in work engagement, and 21% of variance of ascribed importance of religious activity. The SDS-5 can be used as a specific measure of spiritual crisis with good reliability and validity in further studies

Die Corona-Pandemie als Herausforderung für Spiritual Care: Handreichung für Seelsorger/-innen

Spiritual Care bleibt auch in Zeiten der Pandemie des Coronavirus ein wesentlicher Bestandteil der Betreuung kritisch kranker und sterbender Patienten und ihrer Familienangehörigen. Angesichts gesteigerter Sicherheitsbestimmungen mit eingeschränktem Zugang und erheblichen Belastungen für alle Mitarbeitenden im Gesundheitswesen müssen Seelsorger klären, wie sie zu einer ganzheitlichen Versorgung von Patienten, Familienmitgliedern und Mitarbeitern beitragen können, ohne die Selbstsorge und die Sorge für die eigene Gesundheit zu vernachlässigen. Fragen der Kommunikation, z. T. mit technischen Hilfsmitteln, der Durchführung von Ritualen, einschließlich der Versorgung von Toten und der Begleitung trauernder Familienmitglieder werden diskutiert. Existenzieller Belastung bei Angehörigen der Gesundheitsberufe können Seelsorgende mit Angeboten begegnen. Besonderes Augenmerk verlangen Seelsorge und Spiritual Care in Pflegeeinrichtungen sowie ethische Fragen der Entscheidungsfindung bei Triage

Holistic care program for elderly patients to integrate spiritual needs, social activity, and self-care into disease management in primary care (HoPES3): study protocol for a cluster-randomized trial

Background: Strategies to improve the care of elderly, multimorbid patients frequently focus on implementing evidence-based knowledge by structured assessments and standardization of care. In Germany, disease management programs (DMPs), for example, are run by general practitioners (GPs) for this purpose. While the importance of such measures is undeniable, there is a risk of ignoring other dimensions of care which are essential, especially for elderly patients: their spiritual needs and personal resources, loneliness and social integration, and self-care (i.e., the ability of patients to do something on their own except taking medications to increase their well-being). The aim of this study is to explore whether combining DMPs with interventions to address these dimensions is feasible and has any impact on relevant outcomes in elderly patients with polypharmacy. Methods: An explorative, cluster-randomized controlled trial with general practices as the unit of randomization will be conducted and accompanied by a process evaluation. Patients aged 70 years or older with at least three chronic conditions receiving at least three medications participating in at least one DMP will be included. The control group will receive DMP as usual. In the intervention group, GPs will conduct a spiritual needs assessment during the routinely planned DMP appointments and explore whether the patient has a need for more social contact or self-care. To enable GPs to react to such needs, several aids will be provided by the study: a) training of GPs in spiritual needs assessment and training of medical assistants in patient counseling regarding self-care and social activity; b) access to a summary of regional social offers for seniors; and c) information leaflets on nonpharmacological interventions (e.g., home remedies) to be applied by patients themselves to reduce frequent symptoms in old age. The primary outcome is health-related self-efficacy (using the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES-6G)). Secondary outcomes are general self-efficacy (using the General Self-Efficacy Scale (GSES)), physical and mental health (using the Short-Form Health Survey (SF-12)), patient activation (using the Patient Activation Measure (PAM)), medication adherence (using the Medication Adherence Report Scale (MARS)), beliefs in medicine (using the Beliefs About Medicines Questionnaire (BMQ)), satisfaction with GP care (using selected items of the European Project on Patient Evaluation of General Practice (EUROPEP)), social contacts (using the 6-item Lubben Social Network Scale (LSNS-6)), and loneliness (using the 11-item De-Jong-Gierveld Loneliness Scale (DJGS-11)). Interviews will be conducted to assess the mechanisms, feasibility, and acceptability of the interventions. Discussion: If the interventions prove to be effective and feasible, large-scale implementation should be sought and evaluated by a confirmatory design. Trial registration: German Clinical Trials Register (DRKS), DRKS00015696 . Registered on 22 January 2019

The International NERSH Data Pool-A Methodological Description of a Data Pool of Religious and Spiritual Values of Health Professionals from Six Continents

Collaboration within the recently established Network for Research on Spirituality and Health (NERSH) has made it possible to pool data from 14 different surveys from six continents. All surveys are largely based on the questionnaire by Curlin " Religion and Spirituality in Medicine, Perspectives of Physicians" (RSMPP). This article is a methodological description of the process of building the International NERSH Data Pool. The larger contours of the data are described using frequency statistics. Five subscales in the data pool (including the already established DUREL scale) were tested using Cronbach's alpha and Principal Component Analysis (PCA) in an Exploratory Factor Analysis (EFA). 5724 individuals were included, of which 57% were female and the mean age was 41.5 years with a 95% confidence interval (CI) ranging from 41.2 to 41.8. Most respondents were physicians (n = 3883), nurses (n = 1189), and midwives (n = 286);but also psychologists (n = 50), therapists (n = 44), chaplains (n = 5), and students (n = 10) were included. The DUREL scale was assessed with Cronbach's alpha (ff = 0.92) and PCA confirmed its reliability and unidimensionality. The new scales covering the dimensions of "Religiosity of Health Professionals (HPs)" (alpha = 0.89), "Willingness of Physicians to Interact with Patients Regarding R/S Issues" (alpha = 0.79), "Religious Objections to Controversial Issues in Medicine" (alpha = 0.78), and "R/S as a Calling" (alpha = 0.82), also proved unidimensional in the PCAs. We argue that the proposed scales are relevant and reliable measures of religious dimensions within the data pool. Finally, we outline future studies already planned based on the data pool, and invite interested researchers to join the NERSH collaboration